Department of Otorhinolaryngology, Queen Elizabeth University Hospital, Glasgow, Scotland.
J Int Adv Otol. 2021 Mar;17(2):103-108. doi: 10.5152/JIAO.2021.8572.
To explore the usefulness of the responses of video head impulse testing (vHIT) in assessing symptomatic patients with superior semicircular canal dehiscence (SSCD).
This was a prospective case-control study performed in a tertiary skull base referral Centre in the UK. It included all patients ¬diagnosed with SSCD from January 2015 to January 2019 and compared to a control group of age and gender-matched unaffected indi¬viduals. The main outcome of the study was semicircular canal vestibule-ocular reflex (VOR) gains during vHIT assessment and link to patients' symptoms.
A total of 28 patients were diagnosed with SSCD during the study period and completed the vHIT assessment. Reduced VOR gains (<0.8) were noted in 57% of patients (n = 16). Half of these (n = 8) were in canals other than the superior semicircular (posterior only: n = 5; lateral and posterior: n = 3). Three patients (10.7%) had abnormal responses in 2 canals. The canals in the contralateral side were affected in 56.5% of the cases. There was no correlation with the patients' symptoms. Results were directly comparable with the control group vHIT results with no identifiable statistically significant differences on comparison of the ipsilateral SSCD side with a randomly selected side from the control group (all comparisons: P > .05).
SSCD can affect the vestibular responses from all 3 semicircular canals; not necessarily the superior one. Similar responses were found in a control group of normal subjects. Although the use of vHIT in the assessment of SSCD is not diagnosis-specific, it can still help with identifying the impact of surgery on all canals prior to any intervention in order to avoid bilateral vestibular failure.
探讨视频头脉冲试验（vHIT）对有症状的上半规管裂患者的反应在评估中的作用。
这是一项在英国的一个三级颅底转诊中心进行的前瞻性病例对照研究。它包括 2015 年 1 月至 2019 年 1 月期间所有被诊断为上半规管裂的患者，并与年龄和性别匹配的未受影响的对照组进行比较。该研究的主要结果是 vHIT 评估时半规管前庭眼反射（VOR）增益以及与患者症状的关系。
在研究期间，共有 28 例患者被诊断为上半规管裂，并完成了 vHIT 评估。57%的患者（n=16）的 VOR 增益降低（<0.8）。其中一半（n=8）的 VOR 增益降低发生在上半规管以外的其他半规管（只有后半规管：n=5；外半规管和后半规管：n=3）。3 例患者（10.7%）在 2 个半规管中有异常反应。56.5%的病例对侧半规管受到影响。与患者的症状无相关性。与对照组的 vHIT 结果直接比较，无统计学意义上的差异（所有比较：P>.05）。
上半规管裂可影响所有 3 个半规管的前庭反应；不一定是上半规管。在正常对照组中也发现了类似的反应。虽然 vHIT 在评估上半规管裂中的使用不是特定于诊断的，但它仍然可以帮助识别手术对所有半规管的影响，以便在进行任何干预之前避免双侧前庭功能衰竭。
