Malara Pasquale, Castellucci Andrea, Martellucci Salvatore
Audiology & Vestibology Service, Centromedico Bellinzona, Bellinzona, Switzerland.
ENT Unit, Department of Surgery, Arcispedale Santa Maria Nuova, AUSL - IRCCS, Reggio Emilia.
Audiol Res. 2020 Jul 7;10(1):236. doi: 10.4081/audiores.2020.236.
Diagnosing the affected side in Benign Paroxysmal Positional Vertigo (BPPV) involving the Lateral Semicircular Canal (LSC) is often challenging and uncomfortable in patients with recent onset of vertigo and intense autonomic symptoms. The Minimum Stimulus Strategy (MSS) aims to diagnose side and canal involved by BPPV causing as little discomfort as possible to the patient. The strategy applied for LSC-BPPV includes the evaluation of pseudo-spontaneous nystagmus and oculomotor responses to the Head Pitch Test (HPT) in upright position, to the seated-supine test and to the Head Yaw Test (HYT) while supine. Matching data obtained by these tests enables clinicians to diagnose the affected side in LSC-BPPV. The purpose of this preliminary study is to propose a new diagnostic test for LSC-BPPV complimentary to the HPT, the Upright Head Roll Test (UHRT), to easily determine the affected ear and the involved arm in the sitting position and to evaluate its efficiency. Our results suggest that the UHRT can increase the sensitivity of the MSS without resorting to the HYT, thus reducing patient's discomfort.
在近期发作眩晕且伴有强烈自主神经症状的患者中，诊断涉及水平半规管（LSC）的良性阵发性位置性眩晕（BPPV）的患侧往往具有挑战性且会让患者感到不适。最小刺激策略（MSS）旨在诊断由BPPV累及的患侧和半规管，同时尽量减少对患者造成的不适。应用于LSC-BPPV的策略包括评估伪自发性眼震以及在直立位时对头部俯仰试验（HPT）、坐位-仰卧位试验和仰卧位时头部偏航试验（HYT）的动眼反应。通过这些试验获得的数据匹配，使临床医生能够诊断LSC-BPPV的患侧。这项初步研究的目的是提出一种针对LSC-BPPV的新诊断试验，作为对HPT的补充，即直立位头部滚动试验（UHRT），以便在坐位时轻松确定患耳和受累半规管，并评估其有效性。我们的结果表明，UHRT可以在不借助HYT的情况下提高MSS的敏感性，从而减轻患者的不适。
