Tian Liang, Chen Zhongchun, Wang Jinyu, Zhang Lei, Zhao Hao, Chi Fanglu, Wang Jing
Ear, Nose, Throat (ENT) Institute and Department of Otorhinolaryngology, Eye and ENT Hospital, Fudan University, Shanghai, China.
National Health Council Key Laboratory of Hearing Medicine (Fudan University), Shanghai, China.
Front Neurol. 2022 Aug 19;13:978490. doi: 10.3389/fneur.2022.978490. eCollection 2022.
To investigate whether otolith dysfunction is related to hearing impairment in vertigo patients with normal semicircular canal function, and to clarify the types of hearing impairment that may be related to otolith organ damage.
The demographic data, pure tone threshold audiometry (PTA) results (air-conduction), data of bithermal and video-head impulse test (vHIT), and vestibular evoked myogenic potential (VEMP) results (reaction threshold, P1-N1 amplitude) of patients with vertigo in outpatient clinic from April 2017 to January 2020 were collected. The clinical records of 51 vertigo patients with normal semicircular canal function were included in this study. Low-frequency, speech-frequency, high-frequency, full-frequency PTA were defined as the average of PTA in different frequency bands, respectively (low: 0.125, 0.25, 0.5 kHz; speech: 0.5, 1, 2 kHz, high: 4, 8 kHz, full 0.125-8 kHz). The correlations between hearing impairment in different frequency bands and otolith function impairment were analyzed.
The mean thresholds of 51 patients (102 ears) in low-PTA, speech-PTA, high-PTA, full-PTA were 20.95 ± 6.01, 21.92 ± 6.90, 40.12 ± 17.47, 26.97 ± 8.53 dB nHL, respectively. Among 102 ears, 87 ears (85.3%) could elicit c-VEMP waveforms and 65 ears (63.7%) had o-VEMP waveforms. The mean threshold and P1-N1 amplitude of c-VEMP were 83.10 ± 6.96 dB nHL and 176.79 ± 103.10 uV, while those of o-VEMP were 87.92 ± 5.99 dB nHL and 21.45 ± 32.22 uV. The mean threshold in high-PTA was significantly linearly correlated with c-VEMP threshold ( = 0.01) and P1-N1 amplitude ( = 0.028). There were not significant linear correlations between the mean threshold in each frequency band of PTA and o-VEMP threshold (low-PTA: = 0.266, speech-PTA: = 0.33, high-PTA: = 0.311) or P1-N1 amplitude (low-PTA: = 0.414, speech-PTA: = 0.069, high-PTA: = 0.08).
There is a positive linear correlation between saccule dysfunction and high-frequency hearing impairment in vertigo patients with normal semi-circular canal function. High frequency hearing loss can be expected in patients who have saccular damage. It suggests that high frequency hearing loss in PTA may act as a screening index that otolith organ function should be comprehensively evaluated.
探讨在半规管功能正常的眩晕患者中，耳石功能障碍是否与听力损害相关，并明确可能与耳石器官损害相关的听力损害类型。
收集2017年4月至2020年1月门诊眩晕患者的人口统计学数据、纯音听阈测定（PTA）结果（气导）、冷热试验及视频头脉冲试验（vHIT）数据，以及前庭诱发肌源性电位（VEMP）结果（反应阈、P1-N1波幅）。本研究纳入51例半规管功能正常的眩晕患者的临床记录。低频、言语频率、高频、全频PTA分别定义为不同频带PTA的平均值（低频：0.125、0.25、0.5kHz；言语：0.5、1、2kHz，高频：4、8kHz，全频0.125 - 8kHz）。分析不同频带听力损害与耳石功能损害之间的相关性。
51例患者（102耳）的低频PTA、言语PTA、高频PTA、全频PTA平均听阈分别为20.95±6.01、21.92±6.90、40.12±17.47、26.97±8.53dB nHL。102耳中，87耳（85.3%）可引出c-VEMP波形，65耳（63.7%）有o-VEMP波形。c-VEMP的平均阈和P1-N1波幅分别为83.10±6.96dB nHL和176.79±103.10μV，o-VEMP的分别为87.92±5.99dB nHL和21.45±32.22μV。高频PTA平均听阈与c-VEMP阈（r = 0.01）及P1-N1波幅（r = 0.028）呈显著线性相关。PTA各频带平均听阈与o-VEMP阈（低频PTA：r = 0.266，言语PTA：r = 0.33，高频PTA：r = 0.311）或P1-N1波幅（低频PTA：r = 0.414，言语PTA：r = 0.069，高频PTA：r = 0.08）之间无显著线性相关。
在半规管功能正常的眩晕患者中，球囊功能障碍与高频听力损害呈正线性相关。球囊损害的患者可能出现高频听力损失。提示PTA中的高频听力损失可作为全面评估耳石器官功能的筛查指标。
