Liang Min, Wu Hui, Chen Jianyong, Zhang Qin, Li Shuna, Zheng Guiliang, He Jingchun, Chen Xiangping, Duan Maoli, Yang Jun, Jin Yulian
Department of Otolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Neurol. 2022 Nov 2;13:1017608. doi: 10.3389/fneur.2022.1017608. eCollection 2022.
This study investigates the association between vestibular function and prognosis in patients with unilateral idiopathic sudden sensorineural hearing loss (UISSNHL).
A retrospective analysis of 64 patients with UISSNHL was performed. Pure tone audiometry and vestibular function tests for otoliths and semicircular canals were performed to assess the influence of vestibular functional status on the outcome of patients with UISSNHL.
Patients with abnormal cervical vestibular evoked myogenic potential (cVEMP) or ocular vestibular evoked myogenic potential (oVEMP) responded less favorably to treatment. In the ineffective group, cVEMP was normal in four patients (6.3%) and oVEMPs in three (4.7%). Meanwhile, cVEMP was abnormal in 32 patients (50.0%) and oVEMP in 33 (51.6%). Better hearing recovery occurred in those with normal cVEMP (33.76 ± 15.07 dB HL improvement) or oVEMP (32.55 ± 19.56 dB HL improvement), but this was not the case in those with normal caloric tests. Patients with abnormalities in both cVEMP and oVEMP were less responsive to treatment and had worse hearing recovery than those with normal results in only one of the two tests.
Abnormal oVEMP and/or cVEMP results indicate poor auditory outcomes in patients with UISSNHL. Patients with impaired otolith organ function are likely to have a larger and more severe pathological change in their inner ear.
本研究探讨单侧特发性突发性感音神经性听力损失(UISSNHL)患者的前庭功能与预后之间的关联。
对64例UISSNHL患者进行回顾性分析。进行纯音听力测定以及耳石和半规管的前庭功能测试,以评估前庭功能状态对UISSNHL患者预后的影响。
颈前庭诱发肌源性电位(cVEMP)或眼前庭诱发肌源性电位(oVEMP)异常的患者对治疗的反应较差。在无效组中,4例患者(6.3%)的cVEMP正常,3例患者(4.7%)的oVEMP正常。同时,32例患者(50.0%)的cVEMP异常,33例患者(51.6%)的oVEMP异常。cVEMP正常(听力改善33.76±15.07 dB HL)或oVEMP正常(听力改善32.55±19.56 dB HL)的患者听力恢复较好,但冷热试验正常的患者并非如此。cVEMP和oVEMP均异常的患者对治疗的反应较差,且听力恢复比两项测试中仅一项结果正常的患者更差。
oVEMP和/或cVEMP结果异常表明UISSNHL患者的听觉预后较差。耳石器官功能受损的患者内耳可能存在更大、更严重的病理变化。