Toptas Gokhan, Keseroğlu Kemal, Öcal Bülent, Saka Cem, Er Serap, Korkmaz Mehmet Hakan
Department of Head- Neck Surgery, University of Medical Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Turkey.
Department of Audiology and Medical Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Turkey.
Int Tinnitus J. 2021 Jan 25;24(2):54-59. doi: 10.5935/0946-5448.20200012.
Idiopathic subjective tinnitus has a complex pathophysiology in which not only cochlear and central classical auditory pathways but also nonclassical auditory pathways of different parts of the brain are involved. Vestibuloocular and vestibulocollic pathways are the central projections of utricle and saccule used in the vestibular evoked myogenic potential (VEMP) test. Aim of this study was to investigate the effects of idiopathic subjective tinnitus on vestibuloocular and vestibulocollic pathways via VEMP. We prospectively analyzed 30 unilateral idiopathic subjective tinnitus patient's cervical, ocular VEMP tests, tinnitus handicap index scores, symptom duration and compared with contralateral ear and 35 healthy volunteers. The latencies and amplitudes of P1 and N1 waves were recorded and pathologic wave criteria was calculated according to healthy volunteer's data. In cervical VEMP there were significant longer latencies of P1 and N1 waves with respect to contralateral ear and control group. In ocular VEMP test, N1 and P1 latencies and amplitudes were not significantly different. The percentages of pathologic wave of the tinnitus side were not significantly higher in both cervical VEMP and ocular VEMP tests with respect to contralateral side. Tinnitus handicap index scores and symptom duration had no relationship with latency and amplitude of VEMP tests. Although cervical VEMP P1 and N1 latencies were significantly longer, subjective tinnitus did not result in pathological alterations in the VEMP test. Presence of subjective tinnitus is not an influencing factor in the VEMP interpretation.
特发性主观性耳鸣具有复杂的病理生理学机制,其中不仅涉及耳蜗和中枢经典听觉通路,还涉及大脑不同部位的非经典听觉通路。前庭眼反射和前庭颈反射通路是在前庭诱发肌源性电位(VEMP)测试中使用的椭圆囊和球囊的中枢投射。本研究的目的是通过VEMP研究特发性主观性耳鸣对前庭眼反射和前庭颈反射通路的影响。我们前瞻性地分析了30例单侧特发性主观性耳鸣患者的颈部、眼部VEMP测试、耳鸣 handicap指数评分、症状持续时间,并与对侧耳和35名健康志愿者进行比较。记录P1和N1波的潜伏期和波幅,并根据健康志愿者的数据计算病理波标准。在颈部VEMP中,与对侧耳和对照组相比,P1和N1波的潜伏期明显更长。在眼部VEMP测试中,N1和P1的潜伏期和波幅没有显著差异。耳鸣侧在颈部VEMP和眼部VEMP测试中的病理波百分比相对于对侧没有显著更高。耳鸣 handicap指数评分和症状持续时间与VEMP测试的潜伏期和波幅没有关系。虽然颈部VEMP的P1和N1潜伏期明显更长,但主观性耳鸣并未导致VEMP测试出现病理改变。主观性耳鸣的存在不是VEMP解释中的影响因素。