Molnár András, Maihoub Stefani, Tamás László, Szirmai Ágnes
Semmelweis University, Department of Otolaryngology and Head and Neck Surgery, Szigony u. 36., H-1083, Budapest, Hungary.
J Otol. 2022 Jan;17(1):46-49. doi: 10.1016/j.joto.2021.11.001. Epub 2021 Nov 16.
Benign paroxysmal positional vertigo (BPPV) is characterized by vertigo lasting from seconds to minutes, induced by head movements.
Our study aimed to investigate the clinical significance of the caloric vestibular and video head-impulse tests (vHIT) diagnosing the disorder.
68 patients suffering from posterior canal BPPV (25 male, 43 females, mean age SD, 54.5 13.2 years) and 56 patients with a normal functioning vestibular system as control were investigated. Bithermal caloric test and vHIT was performed during the same medical check-up. Canal paresis (CP%), gain (GA) and asymmetry (GA%) parameters were calculated.
The Dix-Hallpike manoeuvre was only positive in 4% of this population. The CP% parameter was only pathologic in two patients, and there was no significant difference between control and BPPV patients (p = 0.76). The GA value was never under 0.8 in this population, but GA% was abnormal in 63.2%. A significant difference comparing the GA% values to the control group was seen (p = 0.034). There was no correlation detected between the CP% and GA% values in BPPV. Regarding the GA% value, 61% sensitivity and 76% specificity was seen.
The Dix-Hallpike manoeuvre was not often positive in the non-acute phase of BPPV; therefore, objective testing is essential. The caloric test does not have clinical significance in BPPV, but vHIT can be helpful based on the GA% parameter.
良性阵发性位置性眩晕（BPPV）的特征是由头部运动诱发的眩晕，持续时间从数秒到数分钟不等。
我们的研究旨在探讨冷热试验前庭功能检查和视频头脉冲试验（vHIT）诊断该疾病的临床意义。
对68例后半规管BPPV患者（男25例，女43例，平均年龄±标准差，54.5±13.2岁）和56例前庭系统功能正常的患者作为对照进行研究。在同一次体检中进行冷热试验和vHIT。计算半规管轻瘫（CP%）、增益（GA）和不对称性（GA%）参数。
Dix-Hallpike手法在该人群中仅4%呈阳性。CP%参数仅在2例患者中为病理性，对照组与BPPV患者之间无显著差异（p = 0.76）。该人群中GA值从未低于0.8，但63.2%的GA%异常。与对照组相比，GA%值存在显著差异（p = 0.034）。BPPV患者的CP%和GA%值之间未检测到相关性。关于GA%值，敏感性为61%，特异性为76%。
Dix-Hallpike手法在BPPV非急性期通常不呈阳性；因此，客观检测至关重要。冷热试验在BPPV中无临床意义，但基于GA%参数，vHIT可能会有帮助。
