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老年性聋患者的前庭功能减退:一项横断面研究。

Vestibular Hypofunction in Patients with Presbycusis: A Cross-Sectional Study.

作者信息

Omer Walid E, Abdulhadi Khalid, Shahbal Saad, Neudert Marcus, Siepmann Timo

机构信息

Audiology Unit, ENT Section, Ambulatory Care Center, Hamad Medical Corporation, Doha 3050, Qatar.

Dresden International University, 01067 Dresden, Germany.

出版信息

J Clin Med. 2024 Dec 19;13(24):7767. doi: 10.3390/jcm13247767.

Abstract

Vestibular Hypofunction (VH) and hearing loss can affect quality of life and lead to disability, especially in the elderly. Studies investigating presbycusis and vestibular function in the aging population have been conducted separately, but few have examined the combination of both conditions in older patients, with inconsistent results that may be due to small sample sizes or heterogeneity in the methods used to assess vestibular function. We aimed to characterize the occurrence of VH in patients with presbycusis using the video head impulse test (vHIT), which is a specific and reliable assessment tool for VH. A prospective, cross-sectional study of 200 individuals was conducted at Hamad Medical Corporation-Qatar in Doha, Qatar. Adults aged 50 years and older with bilateral age-related hearing loss were screened for eligibility and those who were eligible completed the vHIT. Patient history, demographics, audiological and clinical data were collected. VH was defined as vestibulo-ocular reflex (VOR) gain of <0.79 and presence of corrective saccades. In our study population, (n = 200 mean age 64.1 ± 8.4 [Range = 37], 31.5% females), VH was identified in 12 out of 200 patients (6.0%, 95% CI: 3.3-10.1) with bilateral age-related hearing loss (ARHL), equivalent to approximately 1 in 17 patients. VH was detected in the left ear in 11 patients (5.5%, 95% CI: 2.9-9.9), the right ear in five patients (2.5%, 95% CI: 0.8-5.8), and bilaterally in four patients (2.0%, 95% CI: 0.6-5.4). In our study population, vestibular hypofunction was observed in 6% of patients with bilateral symmetrical age-related sensorineural hearing loss, suggesting that vestibular screening may be useful in this population at risk.

摘要

前庭功能减退(VH)和听力损失会影响生活质量并导致残疾,在老年人中尤为如此。针对老年人群中老年性聋和前庭功能的研究是分别进行的,但很少有研究同时考察老年患者这两种情况的组合,结果不一致,这可能是由于样本量小或评估前庭功能的方法存在异质性。我们旨在使用视频头脉冲试验(vHIT)来描述老年性聋患者中VH的发生情况,vHIT是一种针对VH的特异性且可靠的评估工具。在卡塔尔多哈的哈马德医疗公司开展了一项针对200名个体的前瞻性横断面研究。对年龄在50岁及以上、患有双侧年龄相关性听力损失的成年人进行资格筛查,符合条件者完成vHIT。收集患者病史、人口统计学资料、听力学和临床数据。VH定义为前庭眼反射(VOR)增益<0.79且存在矫正性扫视。在我们的研究人群中(n = 200,平均年龄64.1±8.4 [范围 = 37],女性占31.5%),200例双侧年龄相关性听力损失(ARHL)患者中有12例(6.0%,95%置信区间:3.3 - 10.1)被确定为VH,相当于约每17例患者中有1例。11例患者(5.5%,95%置信区间:2.9 - 9.9)左耳检测到VH,5例患者(2.5%,95%置信区间:0.8 - 5.8)右耳检测到VH,4例患者(2.0%,95%置信区间:0.6 - 5.4)双耳检测到VH。在我们的研究人群中,6%双侧对称性年龄相关性感音神经性听力损失患者存在前庭功能减退,这表明在前庭功能减退风险人群中进行前庭筛查可能有用。

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本文引用的文献

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Clinical Practice Guideline: Age-Related Hearing Loss.临床实践指南:与年龄相关的听力损失。
Otolaryngol Head Neck Surg. 2024 May;170 Suppl 2:S1-S54. doi: 10.1002/ohn.750.
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Progress on mechanisms of age-related hearing loss.年龄相关性听力损失的机制研究进展
Front Neurosci. 2023 Aug 30;17:1253574. doi: 10.3389/fnins.2023.1253574. eCollection 2023.
9
Genetics and the Individualized Therapy of Vestibular Disorders.遗传学与前庭疾病的个体化治疗
Front Neurol. 2021 Feb 5;12:633207. doi: 10.3389/fneur.2021.633207. eCollection 2021.
10
Diagnosing vestibular hypofunction: an update.诊断前庭功能减退:更新。
J Neurol. 2021 Jan;268(1):377-385. doi: 10.1007/s00415-020-10139-4. Epub 2020 Aug 7.

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