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应用视频头脉冲试验评估伴有头晕和感音神经性听力损失的复发性多软骨炎患者的半规管功能。

Evaluation of Semicircular Canal Function in Relapsing Polychondritis Patients With Dizziness and Sensorineural Hearing Loss Using Video Head Impulse Test.

机构信息

Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.

出版信息

Otol Neurotol. 2024 Oct 1;45(9):1045-1050. doi: 10.1097/MAO.0000000000004303. Epub 2024 Aug 26.

Abstract

OBJECTIVE

To evaluate semicircular canal function using video head impulse test (vHIT) in relapsing polychondritis (RP) patients presenting with dizziness and sensorineural hearing loss.

STUDY DESIGN

Retrospective case review.

SETTING

Tertiary referral center.

PATIENTS

Three patients with RP underwent vHIT and hearing tests.

INTERVENTION

Diagnostic.

MAIN OUTCOME MEASURES

The gain in vestibulo-ocular reflex (VOR) and the presence of catch-up saccade were examined, and the correlation between semicircular canal dysfunction and hearing loss was investigated.

RESULTS

Of the six ears, five exhibited semicircular canal dysfunction. Among these, one ear showed dysfunction in two semicircular canals, while the remaining four ears demonstrated dysfunction in all three semicircular canals. Sensorineural hearing loss, ranging from moderate to profound, was detected by pure-tone audiometry in all six ears. Furthermore, a significant correlation was observed between VOR gain in the horizontal semicircular canal (HSC) and hearing level.

CONCLUSIONS

This study demonstrated semicircular canal dysfunction in RP patients presenting with dizziness and hearing loss using vHIT. Moreover, a significant correlation was found between HSC dysfunction and the severity of hearing loss. While inner ear involvement is a key clinical symptom included in the diagnostic criteria for RP, there have been few reports evaluating vestibular dysfunction, and this is the first report on the evaluation of several cases using vHIT. Accurate assessment of vestibular function by vHIT may facilitate early diagnosis and intervention in RP, potentially improving patient outcomes.

摘要

目的

评估复发性多软骨炎(RP)患者出现眩晕和感音神经性听力损失时的半规管功能,使用视频头脉冲试验(vHIT)。

研究设计

回顾性病例研究。

设置

三级转诊中心。

患者

3 例 RP 患者接受 vHIT 和听力测试。

干预

诊断。

主要观察指标

检查前庭眼反射(VOR)增益和捕获性眼跳的存在,并研究半规管功能障碍与听力损失之间的相关性。

结果

在 6 只耳朵中,有 5 只显示半规管功能障碍。其中,1 只耳朵的两个半规管功能障碍,其余 4 只耳朵的三个半规管均功能障碍。纯音测听显示所有 6 只耳朵均有从中度到重度的感音神经性听力损失。此外,还观察到水平半规管(HSC)VOR 增益与听力水平之间存在显著相关性。

结论

本研究使用 vHIT 显示 RP 患者出现眩晕和听力损失时存在半规管功能障碍。此外,还发现 HSC 功能障碍与听力损失的严重程度之间存在显著相关性。尽管内耳受累是 RP 诊断标准中的一个关键临床症状,但很少有关于前庭功能障碍的报道,这是首次使用 vHIT 评估多个病例的报告。vHIT 对前庭功能的准确评估可能有助于早期诊断和干预 RP,从而改善患者的预后。

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