Batuecas-Caletrío Ángel, Jara Alejandra, Suarez-Vega Victor Manuel, Marcos-Alonso Susana, Sánchez-Gómez Hortensia, Pérez-Fernández Nicolas
Otoneurology Unit, Department of Otorhinolaryngology, Complejo Asistencial Universitario de Salamanca, IBSAL, University of Salamanca, 37004 Salamanca, Spain.
Department of Otorhinolaryngology, Hospital General Universitario Reina Sofía, 30005 Murcia, Spain.
Audiol Res. 2022 Apr 14;12(2):202-211. doi: 10.3390/audiolres12020023.
Although diagnostic criteria have been established for superior canal dehiscence syndrome, cases in which the diagnosis is not easy are frequent. On those occasions, some tests such as vibration-induced nystagmus or vestibular-evoked myogenic potentials can offer invaluable help due to their high sensitivity and specificity.
We studied 30 patients showing superior canal dehiscence or "near-dehiscence" in a CT scan. Skull vibration-induced nystagmus and high frequency ocular vestibular-evoked myogenic potentials are performed in each patient. The aim of the study is to determine how useful both tests are for detection of superior canal dehiscence or near-dehiscence.
Of the 60 temporal bones studied, no dehiscence was the result in 22, near-dehiscence in 17 and a definite finding in 21. In 10/30 patients, there was no SVIN (Skull vibration induced nystagmus) during otoneurological testing, while in 6/30, induced nystagmus was mainly horizontal, and in 14/30 there was vertical up-beating. All patients had a positive oVEMP (Ocular vestibular evoked myiogenic potentials) at 0.5 kHz in both ears and the HFoVEMP (High frequency ocular vestibular evoked myiogenic potentials) response was positive in 25/60 (41.6%) of the ears studied and in 19/30 of the patients evaluated (in 6 it was positive in both ears). Up-beat SVIN will point to a SCD (Superior Canal Dehiscence) mainly when HFoVEMP are present, and when this is negative there is a high probability that it is not a SCD.
When SVIN and HFoVEMP results are added (or combined), they not only improve the possibilities of detecting SCD, but also the affected side.
尽管已经确立了半规管裂综合征的诊断标准，但诊断困难的病例屡见不鲜。在这些情况下，一些检查，如振动性眼震或前庭诱发肌源性电位，因其高敏感性和特异性，可提供宝贵的帮助。
我们研究了30例CT扫描显示半规管裂或“近裂”的患者。对每位患者进行头颅振动诱发眼震和高频眼性前庭诱发肌源性电位检查。本研究的目的是确定这两项检查对检测半规管裂或近裂的有用程度。
在所研究的60侧颞骨中，22侧无裂，17侧为近裂，21侧有明确裂。在30例患者中，10例在耳神经学检查时未出现头颅振动诱发眼震（SVIN），6例诱发眼震主要为水平性，14例为垂直向上跳动性。所有患者双耳在0.5kHz时眼性前庭诱发肌源性电位（oVEMP）均为阳性，在所研究的60耳中，高频眼性前庭诱发肌源性电位（HFoVEMP）反应阳性者有25耳（41.6%），在评估的30例患者中，19例阳性（6例双耳阳性）。向上跳动性SVIN主要在存在HFoVEMP时提示半规管裂（SCD），当HFoVEMP为阴性时，很可能不是SCD。
当SVIN和HFoVEMP结果相加（或联合）时，不仅提高了检测SCD的可能性，还能明确患侧。
