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建议对未经治疗的单侧前庭神经鞘瘤患者进行前庭测试时采用抑制性摇头脉冲测试。

Suppression head impulse testing is recommended for vestibular testing of patients with untreated unilateral vestibular schwannoma.

机构信息

Department of Otolaryngology, Head and Neck Surgery and Audiology, Aalborg University Hospital, Aalborg, Denmark.

Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.

出版信息

Eur Arch Otorhinolaryngol. 2022 Jan;279(1):91-99. doi: 10.1007/s00405-021-06621-y. Epub 2021 Jan 27.

DOI:10.1007/s00405-021-06621-y
PMID:33502546
Abstract

PURPOSE

Suppression head impulse testing (SHIMP) is a new vestibular method capable of quantifying vestibular function. The aim of this study was to evaluate the feasibility of this test in patients with existing or newly diagnosed vestibular schwannoma (VS) patients by comparing the results with the traditionally used video head impulse test (vHIT or HIMP).

METHODS

Fifty-five patients with unilateral VS underwent a wide battery of audiological and vestibular tests. HIMP results were evaluated using newly introduced objective guidelines based on the trace evaluation of pathological saccades. The sensitivity and specificity of HIMP and SHIMP were evaluated and compared. A new SHIMP parameter is presented; the anticompensatory saccade amplitude ratio (ASAR).

RESULTS

We found a marked increase in specificity in HIMP testing using the objective guidelines. SHIMP testing revealed a gain threshold of 0.7 to be optimal in terms of achieving high specificity and sensitivity in relation to HIMP testing. Significant correlations were found between a low ASAR and a high degree of vestibular pathology.

CONCLUSION

The SHIMP test is a viable addition to the standard HIMP test in patients with VS, especially with the addition of the ASAR, which could prove useful in monitoring the residual vestibular function.

TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION

N/A.

摘要

目的

抑制性头脉冲试验(SHIMP)是一种新的前庭检测方法,能够定量评估前庭功能。本研究旨在通过与传统的视频头脉冲试验(vHIT 或 HIMP)比较,评估该方法在单侧前庭神经鞘瘤(VS)患者中的可行性。

方法

55 例单侧 VS 患者接受了广泛的听力学和前庭检查。HIMP 结果采用新引入的基于病理性扫视轨迹评估的客观准则进行评估。评估和比较了 HIMP 和 SHIMP 的敏感性和特异性。提出了一个新的 SHIMP 参数,即代偿性扫视幅度比(ASAR)。

结果

我们发现,使用客观准则可以显著提高 HIMP 测试的特异性。SHIMP 测试发现,增益阈值为 0.7 时,在与 HIMP 测试相关的特异性和敏感性方面具有最佳效果。低 ASAR 与高前庭病变程度之间存在显著相关性。

结论

SHIMP 测试是 VS 患者标准 HIMP 测试的可行补充,尤其是添加 ASAR,这可能有助于监测残余的前庭功能。

试验注册号和注册号日期

无。

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Suppression head impulse testing is recommended for vestibular testing of patients with untreated unilateral vestibular schwannoma.建议对未经治疗的单侧前庭神经鞘瘤患者进行前庭测试时采用抑制性摇头脉冲测试。
Eur Arch Otorhinolaryngol. 2022 Jan;279(1):91-99. doi: 10.1007/s00405-021-06621-y. Epub 2021 Jan 27.
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Suppression Head Impulse Test (SHIMP) versus Head Impulse Test (HIMP) When Diagnosing Bilateral Vestibulopathy.
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