Department of Otolaryngology - Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-Ku, N15W7, Sapporo 0608638, Hokkaido, Japan.
Otol Neurotol. 2022 Jun 1;43(5):587-593. doi: 10.1097/MAO.0000000000003527.
To evaluate semicircular canal function in patients with labyrinthine fistula (LF) due to cholesteatoma by the video Head Impulse Test (vHIT).
Retrospective case review.
Tertiary referral center.
Ten patients with LF due to cholesteatoma and six without LF underwent vestibular examination.
Diagnostic.
The gain in vestibulo-ocular reflex (VOR) and the presence of catch-up saccade were examined for the semicircular canals in patients with LF.
Seven of 10 cases (70.0%) in the fistula group were judged to have semicircular canal dysfunction based on preoperative evaluation. VOR gains in the patients with LF were significantly lower than those in the patients without LF. VOR gain decreased significantly in accordance with the severity of the LF. The postoperative VOR gain more than 6 months after surgery was significantly improved compared with the preoperative VOR gain.
The vHIT is thought to be the most suitable method for evaluating semicircular canal function in patients with LF due to cholesteatoma as it is not influenced by middle ear pathology and can evaluate the function of the vertical canals. The vHIT could predict whether a LF is present or not before surgery, and the vHIT is essential for surgery for patients with LF.
通过视频头脉冲试验（vHIT）评估胆脂瘤性迷路瘘（LF）患者的半规管功能。
回顾性病例研究。
三级转诊中心。
10 例 LF 患者（均为胆脂瘤）和 6 例无 LF 患者接受了前庭检查。
诊断。
检查 LF 患者半规管的前庭眼反射（VOR）增益和有无追赶性眼震。
瘘管组 7 例（70.0%）在术前评估中被判断为半规管功能障碍。LF 患者的 VOR 增益明显低于无 LF 患者。LF 的严重程度与 VOR 增益呈显著负相关。术后 6 个月后 VOR 增益较术前显著改善。
vHIT 被认为是评估胆脂瘤性 LF 患者半规管功能的最适宜方法，因为它不受中耳病理的影响，并且可以评估垂直半规管的功能。vHIT 可在术前预测 LF 是否存在，对于 LF 患者的手术至关重要。
