Department of Otorhinolaryngology, Perking Union Medical College Hospital, Chinese Academy of Medical Sciences Peking Union Medical College, No.1 Shuaifuyuan,Wangfujing, Dongcheng District, 100730, Beijing, China.
Acta Neurochir (Wien). 2022 Nov;164(11):2953-2962. doi: 10.1007/s00701-022-05157-2. Epub 2022 Mar 5.
To investigate the clinical value of electrophysiological tests in indicating pathogenic vascular contact of the 8th nerve in definite vestibular paroxysmia (VP) cases to provide a reference for decompression surgery.
We retrospectively analyzed patients who had vertigo, unilateral tinnitus, or hearing loss and exhibited vascular contact of the 8th cranial nerve by MRI. Participants were classified into the VP or non-VP group according to the criteria of the Bárány Society in 2016. The demographic characteristics and audiological and electrophysiological test results of the two groups were compared. Receiver operating characteristic (ROC) curves were calculated for ABR to determine the best parameters and cutoff values to predict the existence of pathological neurovascular contact in VP.
Thirteen patients in the VP group and 66 patients in the non-VP group were included. VP patients had longer interpeak latency (IPL) I-III and wave III latency compared to non-VP patients (p < 0.001; p < 0.001). According to the ROC analyses, IPL I-III and wave III latency were the best indicators for the diagnosis of VP. The optimal cutoff for IPL I-III was 2.3 ms (sensitivity 84.6%, specificity 95.5%), and that for wave III latency was 4.0 ms (sensitivity 92.3%, specificity 77.3%). There were no differences in the PTA, caloric test, o-VEMP, or c-VEMP results between the two groups.
Prolonged IPL I-III and the wave III latency of ABR strongly suggested that vascular contact of the 8th cranial nerve was pathological, which may provide some references for microvascular decompression surgery of VP.
研究电生理测试在明确诊断的前庭阵发性位置性眩晕（VP）病例中提示第 8 脑神经病发性血管接触的临床价值，为减压手术提供参考。
我们回顾性分析了因眩晕、单侧耳鸣或听力下降且 MRI 显示第 8 颅神经血管接触而就诊的患者。根据 2016 年 Bárány 学会的标准，将患者分为 VP 组或非 VP 组。比较两组患者的人口统计学特征及听力学和电生理检查结果。计算 ABR 的受试者工作特征（ROC）曲线，以确定最佳参数和截断值，预测 VP 中病理性神经血管接触的存在。
VP 组 13 例，非 VP 组 66 例。与非 VP 组相比，VP 患者的 I-III 波间潜伏期（IPL）和 III 波潜伏期更长（p<0.001；p<0.001）。根据 ROC 分析，IPL I-III 和 III 波潜伏期是 VP 诊断的最佳指标。IPL I-III 的最佳截断值为 2.3ms（敏感性 84.6%，特异性 95.5%），III 波潜伏期的最佳截断值为 4.0ms（敏感性 92.3%，特异性 77.3%）。两组间纯音听阈、冷热试验、o-VEMP 或 c-VEMP 结果无差异。
ABR 的 IPL I-III 延长和 III 波潜伏期强烈提示第 8 脑神经血管接触为病理性，这可能为 VP 的微血管减压手术提供一些参考。
