Kentala E
Department of Otolaryngology, University Hospital of Helsinki, Finland.
Am J Otol. 1996 Nov;17(6):883-92.
To characterize otologic causes for vertigo, data on 564 patients with the six most common diseases involving vertigo were retrieved from the database of a computer-aided diagnostic system for neurotologic diseases. The diseases were Meniere's disease, vestibular schwannoma, benign paroxysmal positional vertigo, vestibular neuritis, sudden deafness, and traumatic vertigo. The prevalence of tinnitus in the study population was 76%. The most severe forms of vertigo and nausea were found in vestibular neuritis, whereas the most severe case of tinnitus appeared in Meniere's disease. Of the patients with vestibular schwannoma, 49% had had vertigo. A linear discrimination analysis using case history classified 90% of the patients into correct groups. The key questions discriminating between the diseases concerned the frequency and duration of vertigo attacks, the duration of hearing loss and vertigo, and the occurrence of head injury. Making a correct diagnosis during the first office visit can be difficult, especially for sudden deafness, vestibular schwannoma, and Meniere's disease. Neurotologic and audiometric information was of minor value in distinguishing between these six diseases. Vestibular schwannoma had significantly greater asymmetry in electronystagmography and smaller gains in smooth pursuit in comparison with the other disease. Factorial analysis did not aid the clustering of these diseases.
为了明确眩晕的耳科病因，我们从一个耳科疾病计算机辅助诊断系统的数据库中检索了564例患有六种最常见眩晕相关疾病患者的数据。这些疾病包括梅尼埃病、前庭神经鞘瘤、良性阵发性位置性眩晕、前庭神经炎、突发性耳聋和创伤性眩晕。研究人群中耳鸣的患病率为76%。在前庭神经炎患者中发现了最严重形式的眩晕和恶心，而在梅尼埃病患者中出现了最严重的耳鸣病例。在前庭神经鞘瘤患者中，49%曾有过眩晕。使用病史进行的线性判别分析将90%的患者正确分类。区分这些疾病的关键问题涉及眩晕发作的频率和持续时间、听力损失和眩晕的持续时间以及头部受伤的发生情况。在首次门诊就诊时做出正确诊断可能很困难，尤其是对于突发性耳聋、前庭神经鞘瘤和梅尼埃病。耳科和听力测量信息在区分这六种疾病方面价值不大。与其他疾病相比，前庭神经鞘瘤在眼震电图检查中具有明显更大的不对称性，在平稳跟踪中增益更小。因子分析无助于这些疾病的聚类。
