Tian Lijuan, Liu Xiuli, Yin Yuxi, Wang Luyang, Han Wei
Department of Otorhinolaryngology Head and Neck Surgery，First Affiliated Hospital，Dalian Medical University，Dalian，116011，China.
Department of Otorhinolaryngology Head and Neck Surgery，Yiyang City Center Hospital.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Sep;36(9):670-674. doi: 10.13201/j.issn.2096-7993.2022.09.004.
To understand the occurrence of horizontal semicircular canal functional impairment in patients with common vestibular diseases and to explore the characteristics and clinical value of different evaluation methods of horizontal semicircular canal. From July 2013 to December 2016, patients who attended the vertigo clinic of the First Affiliated Hospital of Dalian Medical University and completed more than three horizontal semicircular canal function tests were retrospectively analyzed. A total of 396 patients diagnosed as vestibular migraine （VM）, Ménière's disease （MD）, benign paroxysmal positional vertigo （BPPV）, vestibular neuritis （VN） and 104 patients with unknown diagnosis were enrolled. The results of caloric test （CT）, rotation test （RT）, head-shaking nystagmus test （HSN） and video head impulse test （vHIT） were collected and the abnormal detection rates of different detection methods were calculated. The sensitivity, specificity and coincidence rate of various detection methods were statistically analyzed using CT as the gold standard. ①The abnormal rates of the four evaluation methods from high to low were HSN, CT, RT, vHIT （51.20%, 50.80%, 25.76%, 19.74%, respectively）; ②Taking CT as the gold standard, among these four common vestibular diseases, the sensitivity and specificity of vHIT were 0.13-0.41 and 0.69-1.00, the sensitivity and specificity of HSN were 0.44-0.76 and 0.29-0.69, and the sensitivity and specificity of RT were 0.25-0.45 and 0.50-0.84;③According to statistical analysis, only HSN and CT results showed no statistically significant difference in the 4 diseases. There was no significant difference between RT and CT in VM and BPPV, and vHIT and CT in BPPV. The abnormal rate of HSN results in common vestibular diseases is highest, and it could be recommended as a routine vestibular function screening item. The specificity of vHIT is highest and worthy of promotion. CT is still an irreplaceable method to evaluate the function of horizontal semicircular canal.
了解常见前庭疾病患者水平半规管功能损害的发生情况，探讨水平半规管不同评估方法的特点及临床价值。回顾性分析2013年7月至2016年12月在大连医科大学附属第一医院眩晕门诊就诊并完成三项以上水平半规管功能检查的患者。共纳入396例诊断为前庭性偏头痛（VM）、梅尼埃病（MD）、良性阵发性位置性眩晕（BPPV）、前庭神经炎（VN）的患者及104例诊断不明的患者。收集冷热试验（CT）、转椅试验（RT）、摇头眼震试验（HSN）及视频头脉冲试验（vHIT）结果，计算不同检测方法的异常检出率。以CT为金标准，对各检测方法的灵敏度、特异度及符合率进行统计学分析。①四种评估方法的异常率由高到低依次为HSN、CT、RT、vHIT（分别为51.20%、50.80%、25.76%、19.74%）；②以CT为金标准，在这四种常见前庭疾病中，vHIT的灵敏度和特异度分别为0.13 - 0.41和0.69 - 1.00，HSN的灵敏度和特异度分别为0.44 - 0.76和0.29 - 0.69，RT的灵敏度和特异度分别为0.25 - 0.45和0.50 - 0.84；③经统计学分析，在4种疾病中仅HSN与CT结果差异无统计学意义。在VM和BPPV中RT与CT差异无统计学意义，在BPPV中vHIT与CT差异无统计学意义。常见前庭疾病中HSN结果异常率最高，可推荐作为常规前庭功能筛查项目。vHIT特异度最高，值得推广。CT仍是评估水平半规管功能不可替代的方法。
