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特发性突发性聋患者的前庭功能及其与预后的关系。

Vestibular functions in patients with idiopathic sudden sensorineural hearing loss and its relation to prognosis.

机构信息

Department of Otorhinolaringology, Audilogy, Firat University Faculty of Medicine, Elazig, Turkey.

Department of Otorhinolaringology, Firat University Faculty of Medicine, Elazig, Turkey.

出版信息

Auris Nasus Larynx. 2022 Jun;49(3):374-382. doi: 10.1016/j.anl.2021.09.009. Epub 2021 Oct 19.

Abstract

OBJECTIVE

Because of the anatomically close relationship between the cochlea and the vestibular organs, cochlear function disorders may be accompanied by vestibular disorders. This study aimed to evaluate vestibular functions in patients with idiopathic sudden sensorineural hearing loss using VEMP, caloric test, and VNG test battery and its relation to prognosis.

MATERIALS AND METHODS

For this study, 42 patients aged 18-55 years with idiopathic sudden sensorineural hearing loss and 30 volunteers who had no hearing and balance problems were included. Audiometry, cVEMP, oVEMP, caloric tests, and VNG tests were performed. Moreover, the effects of age, sex, time of admission, degree and configuration of hearing loss, accompanying vertigo, tinnitus, and ear fullness on improvement in hearing were evaluated.

RESULTS

Of the 42 patients in the study group, 26 (56.52%) were male, 20 (43.48%) were female, and the mean age was 41.54 ± 12.23 years. Of the 30 individuals in the control group, 19 (63.3%) were male, 11 (36.7%) were female, and the mean age was 39.53 ± 13.03 years. There was no significant difference in the incidence of sudden sensorineural hearing loss in terms of sex and age, and the prognosis was better for female patients. Early admission to treatment was a factor of good prognosis; profound hearing loss, bilateral hearing loss and vertigo were factors of poor prognosis. Prognosis was better in patients with rising type audiogram configuration, while the prognosis was worse in patients with flat, descending and total hearing loss. Tinnitus and ear fullness had no effect on the prognosis. No anomalies were observed in VNG findings. Moreover, abnormal caloric response was higher in patients with profound hearing loss and total hearing configuration. Shortening was observed in cVEMP / oVEMP P1 and N1 latency after treatment. Furthermore, there was an improvement in abnormal responses after treatment.

CONCLUSION

In this study, vestibular function was affected in patients with idiopathic sudden sensorineural hearing loss. The present study can help the development of a clinical strategy in the evaluation of the vestibular system in idiopathic SSNHL, patient follow-up, patient information, and the implementation of vestibular rehabilitation. Note that additional studies involving larger patients series are required.

摘要

目的

由于耳蜗与前庭器官在解剖上的密切关系,耳蜗功能障碍可能伴有前庭功能障碍。本研究旨在通过 VEMP、冷热试验和 VNG 试验评估特发性突发性聋患者的前庭功能及其与预后的关系。

材料与方法

本研究纳入 42 例年龄在 18-55 岁的特发性突发性聋患者和 30 例无听力和平衡问题的志愿者。进行了听力测试、cVEMP、oVEMP、冷热试验和 VNG 测试。此外,还评估了年龄、性别、入院时间、听力损失程度和类型、伴随的眩晕、耳鸣和耳闷对听力改善的影响。

结果

在研究组的 42 例患者中,26 例(56.52%)为男性,20 例(43.48%)为女性,平均年龄为 41.54±12.23 岁。在对照组的 30 名个体中,19 名(63.3%)为男性,11 名(36.7%)为女性,平均年龄为 39.53±13.03 岁。在性别和年龄方面,突发性聋的发生率没有显著差异,女性患者的预后较好。早期接受治疗是良好预后的一个因素;重度听力损失、双侧听力损失和眩晕是预后不良的因素。听力图构型为上升型的患者预后较好,而构型为平坦型、下降型和全聋型的患者预后较差。耳鸣和耳闷对预后没有影响。VNG 检查结果无异常。此外,重度听力损失和全聋构型患者的冷热反应异常率较高。治疗后观察到 cVEMP/oVEMP P1 和 N1 潜伏期缩短。此外,治疗后异常反应得到改善。

结论

在本研究中,特发性突发性聋患者的前庭功能受到影响。本研究有助于在特发性 SSNHL 中评估前庭系统,为患者随访、患者信息和前庭康复提供临床策略。需要注意的是,还需要开展更多涉及更大患者系列的研究。

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