原发性良性阵发性位置性眩晕的听力及前庭诱发肌源电位研究

徐志伟; 赵鹏; 杨旭; 刘兴建; 陈先兵; 张素珍; 吴子明

doi:10.13201/j.issn.1001-1781.2015.01.006

原发性良性阵发性位置性眩晕的听力及前庭诱发肌源电位研究

- 1 解放军总医院耳鼻咽喉头颈外科眩晕诊疗中心(北京, 100853);
- 2 解放军第252医院耳鼻咽喉科;
- 3 航天中心医院(北京大学航天临床医学院)神经内科

详细信息

通讯作者: 吴子明,E-mail:zimingwu@126.com

中图分类号: R764.3

收稿日期: 2014-10-29

The hearing and vestibular evoked myogenic potentials test in patients with primary benign paroxysmal positional vertigo

- 1 Center of Diagnosis and Treatment of Vertigo, Department of Otolaryngology-Head and Neck Surgery, General Hospital of PLA, Beijing, 100853, China;
- 2 Department of Otolaryngology, the 252nd Hospital of PLA;
- 3 Department of Neurology, the Aerospace Central Hospital, the Aerospace Clinical Medicial College of Peking University

More Information

Corresponding author: WU Ziming, E-mail: zimingwu@126.com

Received Date: 29 October 2014

摘要

摘要: 目的:对原发性良性阵发性位置性眩晕(BPPV)患者纯音听力及前庭诱发肌源性电位(VEMP)结果进行分析,了解原发性BPPV的听力及VEMP特点,进一步探讨伴与不伴听力损失的原发性BPPV发病与VEMP的相关性。方法:74例原发性BPPV患者行纯音测听、视频眼震图、VEMP检查,分析听力正常与听力损失BPPV患者VEMP结果的差异,探讨差异的可能机制。结果:74例原发性BPPV患者中,听力损失者占23.0%,听力正常者占77.0%;眼眶前庭诱发肌源性电位(oVEMP)正常者15例,异常者59例;颈性前庭诱发肌源性电位(cVEMP)正常者25例,异常者49例。oVEMP与cVEMP异常率在原发性BPPV中差异有统计学意义(P<0.05),cVEMP与oVEMP在伴听力损失的原发性BPPV中差异有统计学意义(均P<0.05)。结论:oVEMP在原发性BPPV中的阳性率高于cVEMP,可能与BPPV发生在椭圆囊有关;cVEMP对伴有听力损失的原发性BPPV的检测阳性率高于oVEMP,可能与耳蜗和球囊发生于相同胚胎组织结构有关。
- 良性阵发性位置性眩晕 /
- 听力损失 /
- 前庭诱发肌源性电位
Abstract: Objective: To investigate the result of vestibular evoked myogenic potentials (VEMP) of primary benign paroxysmal positional vertigo(BPPV)and to identify the characteristics in VEMP examination of the primary BPPV and to observe the relevance of patients with primary BPPV and abnormal VEMP with hearing loss.Method: Patients with primary BPPV were tested with pure tone audiometry, videonystagmograph and VEMPs test.We analyzed the difference in the two groups with normal hearing and hearing loss, discussed the etiology and pathogenesis. Result: Primary BPPV comprised 23.0% with hearing lost, 77.0% hearing normal. The results of oVEMP were abnormal in 79.7%(59/74) of the cases; and the results of cVEMP were abnormal in 66.2%(49/74) of the cases; oVEMP and cVEMP differences to the diagnosis of primary BPPV (P<0.05); oVEMP and cVEMP differences to the diagnosis primary BPPV with hearing lost (P<0.05). Conclusion: oVEMP detection positive rate of primary BPPV is higher than cVEMP,which may be due to otolithic particles falling from the utricle; positive rate of cVEMP in primary BPPV with hearing loss is higher than that of oVEMP, which may related to the cochlear and sacculus occured in the same embryonic tissue structure.
- benign paroxysmal positional vertigo /
- hearing loss /
- vestibular evoked myogenic potentials

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参考文献(16)

[1]	中华耳鼻咽喉头颈外科杂志编辑委员,会中华医学会耳鼻咽喉科学分会.良性阵发性位置性眩晕的诊断依据和疗效评估(2006年,贵阳)[J]. 中华耳鼻咽喉头颈外科杂志, 2007,42(3):163-164.
[2]	张青,宋辉,胡娟,等. 气导短纯音诱发的眼肌前庭诱发肌源性电位在健康青年人群中的波形特征[J].中华耳鼻咽喉头颈外科杂志, 2012,47(1):15-18.
[3]	MC CASLIN D L, JACOBSON G P, HATTON K, et al. The effects of amplitude normalization and EMG targets on cVEMP interaural amplitude asymmetry[J]. Ear Hear, 2013,34:482-490.
[4]	吴子明,张素珍,周娜,等. 良性阵发性位置性眩晕的听-前庭功能研究[J]. 中华耳鼻咽喉头颈外科杂志, 2006,41(9):669-672.
[5]	VON BREVERN M, RADTKE A, LEZIUS F, et al. Epidemiology of benign paroxysmal positional vertigo:a population based study[J]. J Neurol Neurosurg Psychiatry, 2007,78:710-715.
[6]	OGUN O A, BUKI B, COHN E S, et al. Menopause and benign paroxysmal positional vertigo[J]. Menopause, 2014, 21:886-889.
[7]	SCHAAF H, KASTELLIS G,HESS G. Utricular function. Correlation of three investigations carried out in routine practice[J]. HNO, 2013,61:692-698.
[8]	TOWNSEND G L, CODY D T. The averaged inion response evoked by acoustic stimulation:its relation to the saccule[J]. Ann Otol Rhinol Laryngol, 1971,80:121-131.
[9]	UCHINO Y, KUSHIRO K. Differences between otolith- and semicircular canal-activated neural circuitry in the vestibular system[J]. Neurosci Res, 2011,71:315-327.
[10]	JONES S M, ROBERTSON N G, GIVEN S, et al. Hearing and vestibular deficits in the Coch(-/-) null mouse model:comparison to the Coch(G88E/G88E) mouse and to DFNA9 hearing and balance disorder[J]. Hear Res, 2011,272:42-48.
[11]	SHIGA A, NAKAGAWA T, NAKAYAMA M, et al. Aging effects on vestibulo-ocular responses in C57BL/6 mice:comparison with alteration in auditory function[J]. Audiol Neurootol, 2005,10:97-104.
[12]	MOCK B, JONES T A, JONES S M. Gravity receptor aging in the CBA/CaJ strain:a comparison to auditory aging[J]. J Assoc Res Otolaryngol, 2011,12:173-183.
[13]	ZUNIGA M G, DINKES R E, DAVALOS-BICHARA M, et al. Association between hearing loss and saccular dysfunction in older individuals[J]. Otol Neurotol, 2012,33:1586-1592.
[14]	MORITA N, KARIYA S, FARAJZADEH DEROEE A, et al. Membranous labyrinth volumes in normal ears and Meniere disease:a three-dimensional reconstruction study[J]. Laryngoscope, 2009,119:2216-2220.
[15]	IGARASHI M. Histopathological findings after experimental saccular destruction in the squirrel monkey[J]. Laryngoscope, 1965,75:1048-1061.
[16]	吴子明,张素珍,刘兴健,等. 突发性聋继发良性阵发性位置性眩晕的临床观察[J]. 中国听力语言康复科学杂志, 2010,8(1):18-20.