Faculty of Medicine, Reims Champagne-Ardenne University, Reims, France.
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Reims, Reims, France.
J Otolaryngol Head Neck Surg. 2024 Jan-Dec;53:19160216241265091. doi: 10.1177/19160216241265091.
Acute and complete unilateral vestibular deafferentation induces a significant change in ipsilateral vestibuloocular reflex gain, making the patient unable to stabilize gaze during active or passive head movements. This inability creates the illusion that the visual environment is moving, resulting in persistent visual discomfort during rapid angular or linear acceleration of the head. This is known as oscillopsia. Our objective was to understand if the spontaneous sensation of oscillopsias after complete unilateral vestibular deafferentation by vestibular neurotomy at 5 days (D5) and at 3 months (M3) is correlated with the loss of vestibuloocular reflex gain and dynamic visual acuity.
Retrospective cohort study was conducted in an otolaryngology tertiary care center (2019-2022) on patients with complete unilateral vestibular loss by vestibular neurotomy. They were divided into 2 groups according to the presence (group G1) or absence (group G2) of a spontaneous complaint of oscillopsia assessed at M3. Severity of oscillopsias evaluated by Oscillopsia Severity Questionnaire. Vestibuloocular reflex gain based on video head impulse test (vHIT) and the dynamic visual acuity were measured for each group at D5 and M3. Categorical variables were compared using χ test and quantitative variables using the nonparametric Wilcoxon-Mann-Whitney test.
All patients have a complete vestibular deafferentation at D5 and M3. At D5 (G1 = 8 patients, G2 = 5 patients), there is no significant difference for ipsilateral and contralateral vestibuloocular reflex gains and dynamic visual acuity losses. The Oscillopsia Severity Questionnaire was 2.68 ± 1.03 in G1 and 1.23 ± 1.03 in G2 ( < .05). At M3 (G1 = 9 patients, G2 = 6 patients), there is no significant difference between groups for epidemiologic and clinical data and for vestibuloocular reflex and dynamic visual acuity losses. The Oscillopsia Severity Questionnaire was 2.10 ± 0.63 in G1 and 1.24 ± 0.28 in G2 ( < .05).
The spontaneous disabling sensation of oscillopsia after complete unilateral vestibular loss is well assessed by the Oscillopsia Severity Questionnaire but cannot be explained by objective vestibular tests assessing vestibuloocular reflex gain (vHIT) or dynamic visual acuity loss at D5 or M3. Further studies are needed to measure the sensation of oscillopsia under real-life conditions and to identify the factors responsible for its persistence.
Retrospectively registered.
急性且完全单侧前庭失能会导致同侧前庭眼反射增益显著改变，使患者在主动或被动头部运动期间无法稳定注视。这种无法稳定注视的能力会产生视觉环境在移动的错觉，从而导致头部快速角或线性加速时持续出现视觉不适，这被称为视振。我们的目的是了解在 5 天（D5）和 3 个月（M3）时因前庭神经切断术导致的完全单侧前庭丧失后，自发的视振感是否与前庭眼反射增益和动态视力丧失有关。
在耳鼻喉科三级护理中心（2019-2022 年）进行了一项回顾性队列研究，纳入了因前庭神经切断术而完全单侧前庭丧失的患者。他们根据 M3 时是否存在（G1 组）或不存在（G2 组）自发的视振感投诉，分为两组。使用视振严重程度问卷评估视振严重程度。在 D5 和 M3 时，通过视频头脉冲试验（vHIT）测量每组的前庭眼反射增益和动态视力丧失。使用 χ2 检验比较分类变量，使用非参数 Wilcoxon-Mann-Whitney 检验比较定量变量。
所有患者在 D5 和 M3 时均有完全的前庭失能。在 D5 时（G1=8 例，G2=5 例），同侧和对侧前庭眼反射增益以及动态视力丧失无显著差异。G1 的视振严重程度问卷评分为 2.68±1.03，G2 为 1.23±1.03（ < .05）。在 M3 时（G1=9 例，G2=6 例），两组在人口统计学和临床数据以及前庭眼反射和动态视力丧失方面无显著差异。G1 的视振严重程度问卷评分为 2.10±0.63，G2 为 1.24±0.28（ < .05）。
完全单侧前庭丧失后自发出现的视振感可通过视振严重程度问卷很好地评估，但不能用评估前庭眼反射增益（vHIT）或 D5 或 M3 时动态视力丧失的客观前庭测试来解释。需要进一步研究以在现实生活条件下测量视振感，并确定其持续存在的原因。
回顾性注册。
