Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China; Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Ministry of Education, Beijing, China.
Int J Pediatr Otorhinolaryngol. 2024 Jan;176:111781. doi: 10.1016/j.ijporl.2023.111781. Epub 2023 Nov 11.
With the increasing clinical focus on the safety of bilateral cochlear implantation (CI) and the potential risk of bilateral vestibular dysfunction, evaluating vestibular end-organ function in patients with vestibular malformations with accompanying abnormalities has been strongly recommended.
To identify the vestibular-evoked myogenic potential (VEMP) values among children with sensorineural hearing loss (SNHL) with vestibular malformation and assess the effectiveness of VEMP testing for inner ear malformations (IEM) diagnosis.
This study included 96 children (192 ears), including those with vestibular malformations (48 ears), large vestibular aqueduct syndrome (LVAS) (50 ears), and SNHL without IEM (94 ears; control group). All groups underwent ocular and cervical VEMP (oVEMP and cVEMP, respectively) testing. The response rates, VEMP parameters, and wave characteristics were compared.
The cVEMP response rates were 37.5 %, 64 %, and 58.51 % and the oVEMP response rates were 42.86 %, 78.95 %, and 77.27 % in the vestibular malformation, LVAS, and control groups, respectively, and significantly differed between groups (cVEMP: X = 18.228, P<0.001) (oVEMP: X = 7.528, P = 0.023). Significant inter-group differences were observed for the cVEMP and oVEMP latency and amplitude (P < 0.05). The LVAS group's waveform exhibited a prolonged latency and increased amplitude compared with that of the other groups.
Patients with SNHL were highly susceptible to otolith dysfunction, regardless of comorbid vestibular malformation presence. Measuring VEMPs is an effective and rapid evaluation technique for vestibular function and could provide a basis for vestibular rehabilitation training.
随着临床对双侧人工耳蜗植入(CI)安全性的关注度不断增加,以及双侧前庭功能障碍的潜在风险,强烈建议评估伴有异常的前庭畸形患者的前庭终器功能。
确定伴有前庭畸形的感音神经性听力损失(SNHL)儿童的前庭诱发肌源性电位(VEMP)值,并评估 VEMP 测试对内耳畸形(IEM)诊断的有效性。
本研究纳入 96 例儿童(192 耳),包括前庭畸形(48 耳)、大前庭水管综合征(LVAS)(50 耳)和无 IEM 的 SNHL(94 耳;对照组)。所有组均行眼震和颈 VEMP(oVEMP 和 cVEMP)测试。比较各组的反应率、VEMP 参数和波特征。
cVEMP 反应率分别为 37.5%、64%和 58.51%,oVEMP 反应率分别为 42.86%、78.95%和 77.27%,在前庭畸形、LVAS 和对照组中差异有统计学意义(cVEMP:X=18.228,P<0.001)(oVEMP:X=7.528,P=0.023)。cVEMP 和 oVEMP 的潜伏期和振幅在组间存在显著差异(P<0.05)。LVAS 组的波形潜伏期延长,振幅增加,与其他组不同。
伴有 SNHL 的患者极易出现耳石功能障碍,无论是否存在合并的前庭畸形。测量 VEMPs 是一种有效且快速的前庭功能评估技术,可为前庭康复训练提供依据。