Analysis of high frequency semicircular canal function test in patients with unilateral vestibular neuronitis in the acute phase
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摘要: 目的 分析单侧前庭神经炎急性期患者高频半规管功能测试结果，为临床前庭康复策略提供参考。 方法 49例单侧前庭神经炎急性期患者分别进行视频头脉冲试验(vHIT)和前庭自旋转试验(VAT)测试，对其测试结果进行分析。 结果 vHIT测试结果：49例患者均存在一侧水平半规管增益下降；93.88%存在一侧前半规管增益下降；22.45%存在一侧后半规管增益下降。VAT测试结果：①81.63%(40/49)水平增益下降；83.67%(41/49)水平相移异常；63.27%(31/49)水平对称性异常。②32.65%(16/49)垂直增益下降；16.33%(8/49)垂直相移异常。vHIT与VAT对比：①vHIT水平半规管增益下降与VAT水平通路增益下降异常率对比，差异有统计学意义(P < 0.01)；vHIT前半规管增益下降与VAT垂直通路增益下降异常率对比，差异有统计学意义(P < 0.01)；vHIT后半规管增益下降与VAT垂直通路增益下降异常率对比，差异无统计学意义(P>0.05)。②vHIT测试100%患者存在一侧水平半规管增益下降，VAT 63.27%水平对称性异常，差异有统计学意义(P < 0.01)。③vHIT三组半规管增益均下降的患者，VAT垂直通路增益异常率63.64%，vHIT仅水平、前半规管增益下降的患者，VAT垂直通路增益异常率23.68%，两者对比差异有统计学意义(P < 0.05)。 结论 vHIT在单侧前庭神经炎急性期高频半规管功能测试方面优于VAT，VAT可以作为重要补充，二者结合可以更精确地指导患者的前庭康复。Abstract: Objective To analyze results obtained from high frequency semicircular canal function test in patients with unilateral vestibular neuronitis in the acute phase, aiming to provide references for clinical vestibular rehabilitation. Methods A total of 49 patients with unilateral vestibular neuronitis in the acute phase were enrolled in this study. They were subjected to video head impulse test(vHIT) and vestibular autorotation test(VAT). Test results were analyzed in detail. Results vHIT results showed that 100% of patients presented a lower lateral horizontal semicircular canal gain than normal control, 93.88% presented a lower anterior semicircular canal gain, and 22.45% presented a lower posterior semicircular canal gain. VAT results showed: ①81.63%(40/49) of patients had a decline of horizonal VAT gain, 83.67% (41/49) had an abnormal horizonal phase shift, and 63.27%(31/49) had an abnormal horizontal symmetry. ②32.65% (16/49) of patients had a decline of vertical VAT gain, and 16.33%(8/49) had abnormal vertical phase shift. Comparison results between vHIT and VAT data showed: ①There is a statistical difference between the rate of abnormal decline of vHIT horizonal semicircular canal gain and that of abnormal decline of VAT gain(P < 0.01). There is a statistical difference between the rate of abnormal decline of vHIT anterior semicircular canal gain and that of abnormal decline of vertical VAT gain(P < 0.01). No significant difference was found between the rate of abnormal decline of vHIT posterior semicircular canal gain and that of abnormal decline of vertical VAT gain(P>0.05). ②100% of patients presented a lower vHIT lateral horizontal semicircular canal gain than normal one, and 63.27% of patients had an abnormal VAT horizontal symmetry, which was statistically significant(P < 0.01). ③The rate of abnormal decline of vertical VAT gain was 63.64% in patients with all declines of vHIT lateral horizontal, anterior and posterior semicircular canal gain, which was 23.68% in patients with declines of vHIT lateral horizontal and anterior semicircular canal gain. The difference was statistically significant(P < 0.05). Conclusion vHIT is superior to VAT in the high-frequency semicircular canal function test of unilateral vestibular neuronitis patients in the acute phase. VAT can be used as an important supplement, and the combination of vHIT and VAT can more accurately guide the vestibular rehabilitation.
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