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感音神经性听力损失患者主观视觉垂直线试验评估耳石功能:一项分析性横断面研究

Assessment of Otolith Function with Subjective Visual Vertical Test in Sensorineural Hearing Loss: An Analytical Cross - Sectional Study.

作者信息

Chowdary Pinninti Neha, Das Soumyajit, Kalidoss Vinoth Kumar

机构信息

All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh 522503 India.

Department of ENT, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh 522503 India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2024 Aug;76(4):3165-3171. doi: 10.1007/s12070-024-04637-4. Epub 2024 Mar 25.

Abstract

The inner ear is responsible for balance and auditory function. Sensorineural hearing loss (SNHL) affects auditory function across various age groups. Vestibular apparatus, particularly the otolith organ can also be affected in cases of SNHL because of the close proximity of the otolith organs with the cochlea inside the bony labyrinth. The otolith organs can be assessed with Subjective Visual vertical test (SVV), which is a simple, rapid, non-invasive test with high sensitivity and specificity. Present study was conducted with the objective to compare the SVV parameters between normal and SNHL patients and to correlate between the degree of tilt in SVV with severity of SNHL. A convenient sample size of 60 was taken of which 30 were control and 30 were SNHL patients. PTA and SVV were performed on both groups and results were analysed in IBM SPSS version 26. Age stratified analysis between the control group and SNHL group for the age group 20-40 years and for > 40 years revealed a significant statistical difference in the average static SVV ( = 0.019 and  = 0.009 for age group 20-40 years and > 40 years respectively) and dynamic anti clockwise SVV ( = 0.024 and  = 0.031 for age group 20-40 years, and > 40 years respectively) between the control group and the SNHL group. Correlational analysis also shows a moderate correlation between the bone conduction threshold and the various SVV parameters. Statistical difference of SVV parameters between the two groups suggests a possible early involvement of the otolith organ in SNHL. As such the utility of SVV as an early marker for otolith dysfunction needs to be further explored. It may be worthwhile to follow up the patients of SNHL longitudinally and assess the otolith function with SVV at periodic intervals to identify any progression.

摘要

内耳负责平衡和听觉功能。感音神经性听力损失(SNHL)影响各个年龄组的听觉功能。在前庭器官中,尤其是耳石器官,在SNHL病例中也可能受到影响,因为耳石器官与骨迷路内的耳蜗距离很近。耳石器官可以通过主观视觉垂直试验(SVV)进行评估,这是一种简单、快速、非侵入性的试验,具有高灵敏度和特异性。本研究旨在比较正常人和SNHL患者之间的SVV参数,并将SVV中的倾斜程度与SNHL的严重程度进行关联。选取了60例方便样本,其中30例为对照组,30例为SNHL患者。对两组进行了纯音听阈测试(PTA)和SVV,并在IBM SPSS 26版中分析结果。对20 - 40岁和>40岁年龄组的对照组和SNHL组进行年龄分层分析,结果显示平均静态SVV(20 - 40岁年龄组和>40岁年龄组分别为=0.019和=0.009)和动态逆时针SVV(20 - 40岁年龄组和>40岁年龄组分别为=0.024和=0.031)在对照组和SNHL组之间存在显著统计学差异。相关性分析还显示骨传导阈值与各种SVV参数之间存在中度相关性。两组之间SVV参数的统计学差异表明耳石器官可能在SNHL中早期受累。因此,SVV作为耳石功能障碍早期标志物的效用需要进一步探索。对SNHL患者进行纵向随访并定期用SVV评估耳石功能以确定是否有进展可能是值得的。

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