Cohen Helen S, Sangi-Haghpeykar Haleh, Sullivan J Connor, Silver Nathan, Ferreira Liam D, Dong Jen Li, Sweeney Alex D, Peng Angela S
Bobby R Alford Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA.
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA.
Am J Otolaryngol. 2024 Jan-Feb;45(1):104052. doi: 10.1016/j.amjoto.2023.104052. Epub 2023 Sep 17.
Patients often have basic audiometry (BA) but not objective diagnostic tests of the vestibular system (VNG) when complaining of symptoms of a vestibular disorder. The relationship of BA results to VNG results is unknown. This study sought to determine if BA scores are related to impaired VNG scores.
We reviewed electronic medical records at a tertiary care center, for patients seen between 2015 and 2021 who had had both a BA and a VNG (n = 651). BA subtests were pure tone averages, word recognition, and tympanogram. VNG subtests were cervical vestibular evoked myogenic potentials, Dix-Hallpike maneuvers, and bi-thermal caloric tests. All tests were summarized as normal/abnormal.
More subjects had abnormal BA than abnormal VNG scores. Age but not sex was significantly related to abnormal scores. High BP was a significant comorbidity in 15 % of the sample, more in patients with abnormal than normal VNG scores. Although the abnormal BA and abnormal VNG were significantly related, pure tone averages and tympanogram scores were not related to VNG subtests. Abnormal word recognition with both ears combined was significantly related to normal and abnormal bi-thermal caloric tests.
If the clinician needs to know of any VNG impairment, in general, then performing a BA without a VNG might suffice. If the clinician needs information about the details of possible vestibular impairment, then a VNG should be performed.
患者在诉说前庭疾病症状时,通常进行了基本听力测定(BA),但未进行前庭系统的客观诊断测试(VNG)。BA结果与VNG结果之间的关系尚不清楚。本研究旨在确定BA分数是否与VNG分数受损有关。
我们回顾了一家三级医疗中心2015年至2021年间就诊的同时进行了BA和VNG检查的患者的电子病历(n = 651)。BA子测试包括纯音平均值、单词识别和鼓室图。VNG子测试包括颈前庭诱发肌源性电位、Dix-Hallpike动作和双温冷热试验。所有测试结果总结为正常/异常。
BA异常的受试者比VNG异常的受试者更多。年龄而非性别与异常分数显著相关。高血压是15%样本中的显著合并症,在VNG分数异常的患者中比正常患者更多。虽然BA异常和VNG异常显著相关,但纯音平均值和鼓室图分数与VNG子测试无关。双耳合并单词识别异常与双温冷热试验正常和异常显著相关。
如果临床医生总体上需要了解任何VNG损伤情况,那么在不进行VNG的情况下进行BA可能就足够了。如果临床医生需要有关可能的前庭损伤细节的信息,那么应该进行VNG检查。