Morgenstern C, Greven C
HNO. 1986 Aug;34(8):325-6.
After stapedectomy otoliths were displaced from the endolymphatic space to the cupula of the posterior semicircular canal and caused a paroxysmal benign positional nystagmus which lasted 18 months. The positional nystagmus demonstrated a rotatory component during the Hallpike manoeuvre. The paroxysmal benign nystagmus disappeared after transtympanic nerve neurectomy of the inferior branch of the vestibular nerve (Gacek 1974). This procedure is only recommended for vertigo lasting longer than 1 year. The current findings support the theory that cupulolithiasis is the cause of paroxysmal benign positional nystagmus which can occur after stapedectomy. The rotatory nystagmus is generated in the posterior semicircular canal.
镫骨切除术后,耳石从内淋巴间隙移位至后半规管壶腹,引发了持续18个月的阵发性良性位置性眼球震颤。在Hallpike手法检查期间,位置性眼球震颤表现出旋转成分。经鼓室前庭神经下支神经切除术(Gacek,1974年)后,阵发性良性眼球震颤消失。此手术仅推荐用于眩晕持续超过1年的情况。目前的研究结果支持了这样一种理论,即壶腹嵴顶耳石症是镫骨切除术后可能发生的阵发性良性位置性眼球震颤的病因。旋转性眼球震颤在后半规管中产生。