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[旋转冲动试验不能替代冷热试验]。

[Rotatory impulse test does not replace caloric tests].

作者信息

Ulmer E, Herman P, Toupet M, Gentine A, Negrevergne M, Boussens J, Duclaux R, Biboulet R, Estève-Fraysse M J, Dumas G, Tronche S, Huy P T

机构信息

Service ORL, Hôpital Nord, Marseille.

出版信息

Ann Otolaryngol Chir Cervicofac. 1997;114(5):165-75.

PMID:9686027
Abstract

We sought to determine whether the rotatory impulsional test was capable of exploring the canalar function with sufficient precision to replace the caloric test, as it has been recently affirmed. We first compared the observed preponderance from this test with that measured during a sinusoidal (20 and 4 s) test. We observed that, in the case of a significant preponderance for a given test, there was complete redondance with the preponderance observed with any other test. The rotatory impulsional test does not present any specific advantage compared to other kinetic test as far as the observation of the preponderance phenomenon. We then compared the preponderance with the results of the caloric tests and came to the following conclusions i) the absence of preponderance does not allow us to predict the absence of vestibular deficit, due to the fact that 37% of the deficits were compensated for including acoustic neuroma; ii) the presence of a preponderance does not allow a priori to say whether it is of vestibular, cervical, or central origin and systematic caloric tests shows that almost one fourth of preponderance observed is not associated with unilateral weakness iii) supposing that a clinical argument allow us to conclude as to the probable vestibular origin of a vestibular preponderance, the direction of this preponderance does not allow us to determine which side is involved. In fact, if the undercompensated deficits are 3 times more frequent than overcompensated deficits, the proportion of preponderance not linked to a significant deficit indicates that the probability of encountering a preponderance related to a specific undercompensated deficit is approximately 50%. We thus did not find in the rotatory impulsional test any specific advantage allowing us to predict the laterality of a vestibular lesion.

摘要

正如最近所断言的,我们试图确定旋转脉冲试验是否能够以足够的精度探索半规管功能,从而取代冷热试验。我们首先将该试验观察到的优势偏向与正弦波(20秒和4秒)试验期间测得的优势偏向进行比较。我们观察到,在给定试验存在显著优势偏向的情况下,与任何其他试验观察到的优势偏向完全一致。就优势偏向现象的观察而言,与其他动力学试验相比,旋转脉冲试验没有任何特定优势。然后,我们将优势偏向与冷热试验结果进行比较,得出以下结论:i)不存在优势偏向并不能让我们预测不存在前庭功能缺陷,因为37%的功能缺陷包括听神经瘤都得到了代偿;ii)存在优势偏向并不能凭先验判断其起源是前庭性、颈性还是中枢性,系统的冷热试验表明,观察到的优势偏向中几乎四分之一与单侧无力无关;iii)假设临床依据使我们能够推断前庭优势偏向可能起源于前庭,该优势偏向的方向并不能让我们确定受累的是哪一侧。事实上,如果未代偿的功能缺陷比过度代偿的功能缺陷多3倍,与明显缺陷无关的优势偏向比例表明,遇到与特定未代偿缺陷相关的优势偏向的概率约为50%。因此,我们在旋转脉冲试验中没有发现任何能够让我们预测前庭病变侧别的特定优势。

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