突发性聋伴眩晕患者前庭功能检查及其临床意义

费世星; 王枫; 王梅红; 黄炎

doi:10.13201/j.issn.1001-1781.2019.08.016

突发性聋伴眩晕患者前庭功能检查及其临床意义

- 浙江中医药大学医学技术学院(杭州, 310053)

详细信息

通讯作者: 王枫,E-mail:wf@zcmu.edu.cn

中图分类号: R764.43

收稿日期: 2019-01-19

Vestibular function test in patients sudden sensorineural hearing loss patients with vertigoand its clinical significance

- 1 Department of Otorhinolaryngology Head and Neck Surgery, Zhongshan Hospital of Sun Yat-Sen University and Zhongshan City People's Hospital, Zhongshan, 528400, China;

More Information

Corresponding author: WANG Feng, E-mail: wf@zcmu.edu.cn

Received Date: 19 January 2019

摘要

摘要: 目的:分析突发性聋(突聋)伴眩晕患者前庭功能检查结果及其临床价值。方法:对12例单侧突聋伴眩晕患者(突聋组)进行颈肌前庭诱发肌源性电位(cVEMP)、眼肌前庭诱发肌源性电位(oVEMP)检查及冷热试验,以性别、年龄与突聋组相匹配的11例(22耳)正常人作为对照(对照组),分析突聋组患耳、健侧耳、对照组3组cVEMP、oVEMP的引出率及各参数变化和冷热试验结果。结果:突聋组患耳、健侧耳及对照组oVEMP引出率分别为25.0%、50.0%、90.9%,cVEMP引出率分别为58.3%、58.3%、90.9%,突聋组患耳和健侧耳相比,oVEMP和cVEMP的引出率差异均无统计学意义(P>0.05)。突聋组患耳及健侧耳分别与对照组比较,oVEMP和cVEMP引出率均显著降低(P<0.05),阈值均明显高于对照组(P<0.05),但各波潜伏期、振幅差异均无统计学意义(P>0.05)。突聋组12例患者均行冷热试验,其中9例水平半规管功能明显减弱,异常率为75％。结论:突聋伴眩晕患者存在同侧及对侧前庭通路的传导功能受损,主要表现为VEMP引出率下降、阈值升高及冷热试验异常。前庭功能检查为评估突聋伴眩晕患者的内耳损伤提供了客观依据。
- 听觉丧失 /
- 突发性 /
- 眩晕 /
- 前庭诱发肌源性电位 /
- 冷热试验
Abstract: Objective: The aim of this study is to analyze the results of vestibular function tests and clinical value of patients with sudden sensorineural hearing loss (SSHL) and vertigo. Method: Twelve cases(24 ears) of unilateral SSHL with vertigo were included in the study group. 11 age and sex matched normal subjects(22 ears) were recruited as the normal control group. Both patients and normal subjects underwent carolic tests, ocular vestibular evoked myogenic potential (oVEMP), and cervical vestibular evoked myogenic potential (cVEMP) in bilateral ears. The results were compared between the subjects and the normal control group. Result: The rate of positive oVEMP was 25.0% in the affected ear and 50.0% in the contralateral ear in patients with SSHL and vertigo, and 90.9% in normal subjects; while the rate of positive cVEMP was 58.3% in the affected ear and 58.3% in the contralateral ear in patients with SSHL and vertigo, and 90.9% in normal subjects. There were no significant differences between the affected and contralateral ears (P>0.05). Compared to normal subjects, oVEMP and cVEMP in both the affected and contralateral ears were significantly reduced (P<0.05). The parameters of oVEMP and cVEMP (N1 latency, P1 latency, amplitudes) were not significantly different among the groups(P<0.05). Compared to normal subjects, the threshold difference of oVEMP and cVEMP in both the affected and contralateral ears werehigher than the normal subjects(P<0.05). Among 12 SSHL patients who underwent caloric test, 9 were found with unilateral semicircular canal weakness(CP>25%), and the abnormal rate was 75% (9/12). Conclusion: Patients with vertigo with vertigo have impaired conduction function in the ipsilateral and contralateral vestibular pathways, mainly due to decreased vestibular evoked myogenic potential, increased threshold, and abnormal cold and heat tests. The vestibular function test provides an objective basis for assessing the inner ear injury in patients with vertigo.
- hearing loss /
- sudden /
- vertigo /
- vestibular evoked myogenic potential /
- caloric test

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