Universidade Federal de São Paulo (Unifesp), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ambulatório de Otoneurologia, São Paulo, SP, Brazil.
Universidade Federal de São Paulo (Unifesp), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ambulatório de Otoneurologia, São Paulo, SP, Brazil.
Braz J Otorhinolaryngol. 2020 Mar-Apr;86(2):247-254. doi: 10.1016/j.bjorl.2019.10.001. Epub 2019 Nov 2.
Sudden hearing loss is an otorhinolaryngological emergency that often leads to severe damage to the auditory and vestibular function. The vestibular evoked myogenic potential is a test that allows a noninvasive evaluation of the otolithic system function and vestibulospinal and vestibulo-ocular pathways.
To evaluate the importance of vestibular evoked myogenic potential in determining the prognosis of patients with sudden hearing loss.
A search for articles published up to December 2018 was performed in the PubMed, Cochrane, VHL and LILACS databases using MeSH descriptors. Retrospective and prospective articles were included containing cervical or ocular vestibular evoked myogenic potential in sudden hearing loss patients and information on associated vertigo and/or dizziness.
Sixteen of 62 initially selected articles met the inclusion criteria and were analyzed. Regarding the methodology of the evaluated studies, 8 studies were prospective, six were retrospective, one contained part of the data from a retrospective analysis and another part from a prospective analysis, and one study was cross-sectional. A total of 872 patients were evaluated (50.22% males and 49.77% females) with a mean age of 51.26 years. Four hundred and twenty-six patients (50.35%) had vertigo and/or dizziness associated with sudden hearing loss. The cervical vestibular evoked myogenic potential was performed in all studies, but only seven assessed the ocular vestibular evoked myogenic potential. The cervical vestibular evoked myogenic potential showed alterations in 38.65% of 846 evaluated ears, whereas ocular vestibular evoked myogenic potential showed alterations in 47.88% of 368 evaluated ears. The hearing recovery rate was analyzed by 8 articles, with 63.4% of 410 evaluated ears showing hearing recovery.
The studies suggest that the assessment of the vestibular system using vestibular evoked myogenic potential seems to be important in the prognosis of sudden hearing loss. For better follow-up of patients with sudden hearing loss, the emphasis should not be limited to the cochlea, but also include the diagnosis and treatment of vestibular abnormalities, regardless of the presence of vertigo.
突发性听力损失是一种耳鼻喉科急症，常导致听觉和前庭功能严重受损。前庭诱发肌源性电位是一种可无创评估耳石器系统功能以及前庭脊髓和前庭眼动通路的测试。
评估前庭诱发肌源性电位在确定突发性听力损失患者预后中的重要性。
在 PubMed、Cochrane、VHL 和 LILACS 数据库中使用 MeSH 主题词进行了截至 2018 年 12 月的文献检索。纳入包含突发性听力损失患者颈或眼前庭诱发肌源性电位以及与眩晕和/或头晕相关信息的回顾性和前瞻性文章。
最初选择的 62 篇文章中有 16 篇符合纳入标准并进行了分析。关于评估研究的方法学，8 项研究为前瞻性，6 项为回顾性，1 项包含部分回顾性分析数据和部分前瞻性分析数据，1 项为横断面研究。共评估了 872 例患者（50.22%为男性，49.77%为女性），平均年龄为 51.26 岁。426 例（50.35%）患者突发性听力损失伴有眩晕和/或头晕。所有研究均进行了颈前庭诱发肌源性电位检查，但仅 7 项研究评估了眼前庭诱发肌源性电位。846 个评估耳中，38.65%的颈前庭诱发肌源性电位出现改变，368 个评估耳中，47.88%的眼前庭诱发肌源性电位出现改变。8 篇文章分析了听力恢复率，410 个评估耳中，63.4%的听力恢复。
这些研究表明，使用前庭诱发肌源性电位评估前庭系统在突发性听力损失的预后中似乎很重要。为了更好地随访突发性听力损失患者，重点不应仅局限于耳蜗，还应包括对前庭异常的诊断和治疗，无论是否存在眩晕。
