Manzari Leonardo, Graziano Domenico, Tramontano Marco
MSA ENT Academy Center, Cassino, Italy.
IRCCS Santa Lucia Foundation, Rome, Italy.
Audiol Res. 2020 Aug 24;10(2):31-38. doi: 10.4081/audiores.2020.248.
Vestibular neuritis (VN) is one of the most common causes of acute vestibular syndrome (AVS). Quantifying the vestibulo-ocular reflex (VOR) gain by the video Head Impulse Test (vHIT) could provide useful information to diagnose VN. This study aims to retrospectively evaluate the VOR gain values during the acute and subacute stages of the VN and to correlate these values with the patients' dizziness-related handicap. Medical record of 28 patients with VN were reviewed. Patients were assigned to two groups according to the time since the acute vestibular syndrome (AVS). One group with patients assessed within seventy-two hours since the AVS (AVSg) and one group with patients evaluated from four days to six weeks since the AVS (PAVSg). VOR gain was evaluated in all selected patients and correlated to Dizziness Handicap Inventory (DHI). Significant differences were found in the between-subjects analysis in DHI score ( = 0.000) and in the ipsilesional hVOR gain values ( = 0.001). The correlation analysis showed significant results ( = 0.017) between DHI score (40 ± 16.08) and ipsilesional VOR gain (0.54 ± 0.09) in the PAVSg. Patients evaluated within 72 h since the AVS showed anticompensatory saccades (AcS) turning the head toward the contralesional side. Patients with unilateral Superior VN (SVN) could have dissimilar hVOR gain values and DHI score according to the damage of the VIII pair of cranial nerves. AcS in the contralesional side is a sign of acute phase in patients with unilateral SVN.
前庭神经炎（VN）是急性前庭综合征（AVS）最常见的病因之一。通过视频头脉冲试验（vHIT）量化前庭眼反射（VOR）增益可为VN的诊断提供有用信息。本研究旨在回顾性评估VN急性和亚急性期的VOR增益值，并将这些值与患者的头晕相关障碍进行关联。回顾了28例VN患者的病历。根据自急性前庭综合征（AVS）起的时间将患者分为两组。一组是在AVS后72小时内接受评估的患者（AVS组），另一组是在AVS后4天至6周接受评估的患者（PAVS组）。对所有选定患者的VOR增益进行评估，并与头晕残障量表（DHI）进行关联。在受试者间分析中，DHI评分（P = 0.000）和患侧水平VOR增益值（P = 0.001）存在显著差异。相关性分析显示，PAVS组中DHI评分（40±16.08）与患侧VOR增益（0.54±0.09）之间存在显著相关性（P = 0.017）。在AVS后72小时内接受评估的患者出现向对侧转头的反代偿性扫视（AcS）。单侧上半规管VN（SVN）患者根据第八对脑神经的损伤情况，可能有不同的水平VOR增益值和DHI评分。对侧的AcS是单侧SVN患者急性期的一个征象。
