视频头脉冲试验与冷热试验分离：梅尼埃病的标志物？——系统评价和荟萃分析。
Dissociation between video head impulse test and caloric test: a marker of menière's disease? - A systematic review and meta-analysis.
机构信息
Universidade Estadual de Campinas (UNICAMP), Departamento de Otorrinolaringologia, Campinas, SP, Brazil.
Universidade Estadual de Campinas (UNICAMP), Departamento de Otorrinolaringologia, Campinas, SP, Brazil.
出版信息
Braz J Otorhinolaryngol. 2023 Jul-Aug;89(4):101279. doi: 10.1016/j.bjorl.2023.101279. Epub 2023 Jun 3.
OBJECTIVE
To analyze, by means of a systematic review and meta-analysis, the proportion of patients with Meniere's disease who have altered caloric test and vHIT, as well as to determine the prevalence of altered caloric test and normal vHIT dissociation in the diagnosis of Meniere's disease.
METHODS
The literature search had no restriction regarding the period of publication on the following indexed data platforms: PubMed, PubMed PMC, BVS-Bireme, Web of Science, Embase and Cochrane Library. Articles that evaluated patients with Meniere's disease who underwent caloric test and vHIT were included. Two researchers independently conducted the analysis of the articles, promoting the selection and capture of data, following the recommendations of the PRISMA method, and complying with the criteria for articles inclusion and exclusion defined in the research protocol. In case of disagreement during the selection process, a third researcher was included for analysis.
RESULTS
From a total of 427 initial studies, the researchers selected 12 articles, published between 2014 and 2021, with a total of 708 patients evaluated, with a mean age of 52.72 years old. The prevalence of patients with Meniere's disease with altered caloric reflex test was 64% (95% CI 57%‒71%), while the prevalence of altered vHIT was only 28% (95% CI 16%-40%). The prevalence of the altered caloric test + normal vHIT dissociation was 47% (95% CI 37%-57%).
CONCLUSION
The video head impulse test and the caloric test are valuable tools for vestibular assessment. The dissociation of findings between these two tests in patients with Meniere's disease was more prevalent in this meta-analysis and may be a result of the tonotopy of specialized hair cells in the ampullary crest. The prevalence of altered caloric test was 64% and anormal vHIT was 28%. The dissociation caloric asymmetry and normal vHIT was observed in 47% of the patients.
目的
通过系统评价和荟萃分析，分析梅尼埃病患者改变冷热试验和视频头脉冲试验(vHIT)的比例，并确定在梅尼埃病诊断中，冷热试验异常和 vHIT 正常分离的患病率。
方法
文献检索对发表时间没有限制，检索了以下索引数据平台：PubMed、PubMed PMC、BVS-Bireme、Web of Science、Embase 和 Cochrane Library。纳入评估接受冷热试验和 vHIT 的梅尼埃病患者的文章。两名研究人员独立进行文章分析，根据 PRISMA 方法的建议进行选择和数据采集，并遵守研究方案中定义的文章纳入和排除标准。如果在选择过程中存在分歧，将纳入第三名研究人员进行分析。
结果
从最初的 427 项研究中，研究人员选择了 12 篇发表于 2014 年至 2021 年的文章，共评估了 708 例患者，平均年龄为 52.72 岁。梅尼埃病患者冷热反射试验异常的患病率为 64%（95%CI 57%‒71%），而 vHIT 异常的患病率仅为 28%（95%CI 16%-40%）。冷热试验异常+正常 vHIT 分离的患病率为 47%（95%CI 37%-57%）。
结论
视频头脉冲试验和冷热试验是前庭评估的有价值工具。在本荟萃分析中，梅尼埃病患者这两种测试结果之间的分离更为常见，这可能是壶腹嵴的特化毛细胞的音位拓扑的结果。冷热试验异常的患病率为 64%，vHIT 正常的患病率为 28%。在 47%的患者中观察到冷热试验不对称和 vHIT 正常的分离。
Zotero 插件