Manzari Leonardo, Tramontano Marco
MSA ENT Academy Center, Cassino, Italy.
Fondazione Santa Lucia IRCCS, Rome, Italy.
J Int Adv Otol. 2021 Sep;17(5):433-437. doi: 10.5152/iao.2021.21155.
To evaluate the presence of anti-compensatory saccades (AcS) using the video head impulse test (vHIT) in the healthy inner ear in patients with vestibular neuritis (VN) during the acute and subacute stages of VN.
We retrospectively considered a chart review of 2420 patients evaluated for acute vestibular syndrome from 2016 to 2020 in the Cassino (Italy) clinic. Nine hundred fifty-four patients with acute onset of vestibular syndrome who received an instrumental otoneurological assessment within 24 hours from the onset of the symptoms, evaluated by simultaneously using a combination of vHIT, ocular vestibular-evoked myogenic potential (VEMP), and cervical VEMP, were included in the study.
Thirty-two patients with superior VN that showed an altered horizontal canal function when tested with vHIT and quick AcS on the healthy side were enrolled. We found that all patients with VN, evaluated in the first 24 hours from the onset of the symptoms, showed AcS when their head was abruptly and passively turned toward the healthy inner ear side. At follow-up within 8 weeks from the first evaluation, 29 out of 32 patients did not show increased AcS.
Our findings support the hypothesis that the AcS on the healthy side are a clinical sign of vestibular canal hypofunction or paresis in patients affected by the acute stage of VN.
在前庭神经炎（VN）急性和亚急性期，使用视频头脉冲试验（vHIT）评估健康内耳中抗代偿性扫视（AcS）的存在情况。
我们回顾性地查阅了2016年至2020年在意大利卡西诺诊所接受急性前庭综合征评估的2420例患者的病历。纳入了954例前庭综合征急性发作且在症状发作后24小时内接受了仪器耳神经学评估的患者，评估方法同时使用vHIT、眼前庭诱发肌源性电位（VEMP）和颈VEMP。
纳入了32例上半规管VN患者，这些患者在使用vHIT测试时显示水平半规管功能改变，且健康侧存在快速AcS。我们发现，所有在症状发作后24小时内接受评估的VN患者，当头部突然被动转向健康内耳侧时均出现AcS。在首次评估后的8周内进行随访时，32例患者中有29例未出现AcS增加。
我们的研究结果支持以下假设，即健康侧的AcS是VN急性期患者前庭半规管功能减退或麻痹的临床体征。
