Yun Yanning, Chang Huimin, Yang Pan, Xing Juanli
Department of Otorhinolaryngology Head and Neck Surgery，First Affiliated Hospital of Xi'an Jiaotong University School of Medicine，Xi'an，710061，China.
Department of Otolaryngology Headand Neck Surgery，the First Affiliated Hospital of Xi'an Medical University.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Apr;39(4):319-323. doi: 10.13201/j.issn.2096-7993.2025.04.005.
To evaluate the utility of the Rapid Axial Roll Test （RART）, Supine Roll Test （SRT）, and Lying-Down Test （LDT） in determining the affected semicircular canal in cases of horizontal semicircular canal benign paroxysmal positional vertigo （HSC-BPPV）. A total of 330 patients diagnosed with HSCBPPV from September 2022 to September 2023 were collected and divided into three groups based on the different positional tests received: ①SRT Group, ②LDT+SRT Group, ③RART+SRT Group. The trial was divided into two stages: LDT/RART for patients in the first stage, and SRT for patients in the second stage. The elicitation rate of nystagmus among the three groups was compared to evaluate the accuracy in determining the affected semicircular canal in HSCBPPV. Nystagmus was elicited in 84.55% （279/330） of the patients by positional tests. The elicitation rate of nystagmus in the RART+SRT/LDT group was 94.55% （104/110）, in the LDT+SRT group it was 84.11% （90/107）, and in the SRT group it was 69.91% （79/113）. The differences among the three groups were statistically significant （χ²= 23.88, <0.001）. In the ② and ③ groups, there was a statistically significant difference in the elicitation rate of nystagmus between stage Ⅰ （patients with LDT or RART） （χ²=43.842, <0.001）. SRT was performed in the stage Ⅱ, and there was a statistically significant difference in nystagmus extraction rate between the two groups （χ² =4.690, =0.030）. The difference in the proportion of agreement between stage Ⅰ（LDT or RART） and stageⅡ （SRT） in determining the affected side of the semicircular canal was also statistically significant （χ² =40.502, <0.001）. For patients with a consistent diagnosis of the affected semicircular canal, the difference in cure rate was not significant （=0.149）. The Kappa statistic indicated substantial agreement between RART and SRT in terms of eliciting nystagmus （agreement 96.36%, Kappa = 0.730, <0.001）. RART and SRT show a high degree of agreement regarding the elicitation rate of nystagmus. RART is simple and safe, and it can effectively induce the characteristic nystagmus of HSC-BPPV, accurately identify the responsible semicircular canal and provide a more optimized examination protocol for clinical practice in HSCBPPV.
为评估快速轴向翻滚试验（RART）、仰卧翻滚试验（SRT）和卧倒试验（LDT）在确定水平半规管良性阵发性位置性眩晕（HSC - BPPV）病例中患侧半规管方面的效用。收集了2022年9月至2023年9月期间共330例诊断为HSC - BPPV的患者，并根据接受的不同位置试验将其分为三组：①SRT组，②LDT + SRT组，③RART + SRT组。试验分为两个阶段：第一阶段对患者进行LDT/RART，第二阶段对患者进行SRT。比较三组的眼震引出率，以评估在HSC - BPPV中确定患侧半规管的准确性。通过位置试验在84.55%（279/330）的患者中引出了眼震。RART + SRT/LDT组的眼震引出率为94.55%（104/110），LDT + SRT组为84.11%（90/107），SRT组为69.91%（79/113）。三组之间的差异具有统计学意义（χ² = 23.88，<0.001）。在②组和③组中，Ⅰ期（进行LDT或RART的患者）的眼震引出率存在统计学差异（χ² = 43.842，<0.001）。Ⅱ期进行SRT，两组之间的眼震引出率存在统计学差异（χ² = 4.690，=0.030）。Ⅰ期（LDT或RART）和Ⅱ期（SRT）在确定半规管患侧方面的一致性比例差异也具有统计学意义（χ² = 40.502，<0.001）。对于患侧半规管诊断一致的患者，治愈率差异不显著（=0.149）。Kappa统计量表明RART和SRT在引出眼震方面具有高度一致性（一致性为96.36%，Kappa = 0.730，<0.001）。RART和SRT在眼震引出率方面显示出高度一致性。RART简单安全，能有效诱发HSC - BPPV的特征性眼震，准确识别责任半规管，为HSC - BPPV的临床实践提供更优化的检查方案。
