眩晕非急性期外周前庭功能障碍患者的平台姿势描记法

Platform posturography of patients with peripheral vestibular dysfunction in the non-acute phase of vertigo.

作者信息

Shimizu Kotaro, Imai Takao, Oya Ryohei, Okumura Tomoko, Sato Takashi, Osaki Yasuhiro, Ohta Yumi, Inohara Hidenori

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan.

出版信息

Auris Nasus Larynx. 2021 Aug;48(4):577-582. doi: 10.1016/j.anl.2020.10.017. Epub 2020 Nov 11.

DOI:10.1016/j.anl.2020.10.017

PMID:33189459

Abstract

OBJECTIVE

Posturography (PG) shows various patterns corresponding to a patient's equilibrium condition; however, PG is not useful for the differential diagnosis of peripheral vestibular diseases (PVDs). The aim of this study was to identify parameters of PG that can distinguish between PVDs.

METHODS

The differences in PG parameters between PVDs were evaluated retrospectively. Two hundred and two patients with Ménière's disease (MD), 154 patients with benign paroxysmal positional vertigo (BPPV), 20 patients with sudden sensorineural hearing loss with vertigo (SSNHLwV), and 31 patients with vestibular neuritis (VN) underwent PG during the non-acute phase of vertigo, from January 2010 to March 2017.

RESULTS

The velocity of body oscillation of BPPV patients with eyes open and closed were significantly faster than those of MD patients with eyes open (p < 0.001) and closed (p = 0.033). The velocity of body oscillation of VN patients with eyes open was significantly faster than that of MD patients with eyes open (p = 0.0083). There were no significant differences among the other PG parameters between PVDs. Although there were significant differences among the velocity with eyes open and closed between males and females (eye open: p = 0.0009, eye close: p < 0.0001), there was no significant difference in the ratio of males to females among PVDs (p = 0.1834). Therefore, the ratio did not influence the difference in velocity among PVDs. Patient age correlated with the velocity with eyes open (p < 0.001) and with eyes closed (p < 0.001). Post-hoc analysis revealed significant differences in patient age, and comparisons of MD and BPPV, MD and SSNHLwV, BPPV and VN, and VN and SSNHLwV. Therefore, we performed multiple regression analysis to determine whether the significant differences in the velocity of body oscillation among PVDs were caused by the difference in age distribution between PVD groups, rather than by differences in the PVDs themselves. There were correlations between age and the velocity of body oscillation with eyes open (p < 0.001) and with eyes closed (p < 0.001). There also were correlations between MD or VN and the velocity of body oscillation with eyes open (p = 0.0194).

CONCLUSION

There were significant differences in the velocity of body oscillation with eyes open between MD and VN patients. The difference between MD and VN was significant regardless of the age distribution. To distinguish between MD and VN, the velocity of body oscillation with eyes open is a useful PG index.

摘要

目的

姿势描记法（PG）显示出与患者平衡状况相对应的各种模式；然而，PG对外周前庭疾病（PVD）的鉴别诊断并无帮助。本研究的目的是确定PG中能够区分PVD的参数。

方法

回顾性评估PVD之间PG参数的差异。2010年1月至2017年3月，202例梅尼埃病（MD）患者、154例良性阵发性位置性眩晕（BPPV）患者、20例伴眩晕的突发性感音神经性听力损失（SSNHLwV）患者和31例前庭神经炎（VN）患者在眩晕非急性期接受了PG检查。

结果

BPPV患者睁眼和闭眼时身体摆动速度明显快于MD患者睁眼时（p<0.001）和闭眼时（p=0.033）。VN患者睁眼时身体摆动速度明显快于MD患者睁眼时（p=0.0083）。PVD之间的其他PG参数无显著差异。虽然男性和女性睁眼和闭眼时的速度存在显著差异（睁眼：p=0.0009，闭眼：p<0.0001），但PVD之间的男女比例无显著差异（p=0.1834）。因此，该比例不影响PVD之间速度的差异。患者年龄与睁眼时的速度（p<0.001）和闭眼时的速度（p<0.001）相关。事后分析显示患者年龄存在显著差异，且MD与BPPV、MD与SSNHLwV、BPPV与VN以及VN与SSNHLwV之间存在差异。因此，我们进行了多元回归分析，以确定PVD之间身体摆动速度的显著差异是由PVD组之间年龄分布的差异引起的，还是由PVD本身的差异引起的。年龄与睁眼时的身体摆动速度（p<0.001）和闭眼时的身体摆动速度（p<0.001）之间存在相关性。MD或VN与睁眼时的身体摆动速度之间也存在相关性（p=0.0194）。