The application value of video head impulse test, caloric test and dizziness handicap inventory in the diagnosis of acoustic neuroma
-
摘要: 目的 探讨视频头脉冲试验(vHIT)、冷热试验(CT)和眩晕障碍程度评定量表(DHI)诊断听神经瘤(AN)的价值，分析vHIT和CT的相关性，并评估肿瘤大小与vHIT、CT和DHI评分的相关性。方法 回顾分析2019年1月—2022年1月接受手术治疗的24例AN患者临床资料，包括颅脑MRI、vHIT、CT及DHI评分，所有数据采用GraphPad Prism 9.0进行统计学分析。结果 CT的同侧半规管轻瘫(UW)值和vHIT的前庭眼反射(VOR)增益之间存在显著负相关(P < 0.01，r=-0.62)。肿瘤大小与CT的UW值增加呈显著相关(P < 0.01，r=0.69)，与vHIT的VOR增益减少存在相关性(P < 0.01，r=-0.53)。平均DHI评分为(8.9±16.2)分，与肿瘤大小差异无统计学意义(P>0.05)。结论 vHIT和CT均能有效评估AN患者的前庭功能，且具有互补性，均与肿瘤大小相关，对AN的诊断具有一定价值。Abstract: Objective To explore the application value of video head impulse test(vHIT), caloric test(CT) and the dizziness handicap inventory(DHI) in the diagnosis of acoustic neuroma(AN), to analyze the correlation between vHIT and CT, and to determine the correlationsof tumor size, vHIT, CT and DHI score.Methods The clinical data of 24 patients with AN who underwent surgery in our department from January 2019 to January 2022 were analyzed retrospectively, including craniocerebral MRI, vHIT, caloric test and DHI score. All the data were statistically analyzed by GraphPadPrism9.0.Results There was a significant negative correlation between the UW value of CT and the vestibular eye reflex gain of vHIT(P < 0.01, r=-0.62). The tumor size was significantly correlated with the increase of UW value of CT(P < 0.01, r=0.69), and with the decrease of vestibulo-ocular reflex gain of vHIT(P < 0.01, r=-0.53). The average Dizziness Handicap Inventory score was 8.9±16.2, which was not correlated with tumor size(P>0.05).Conclusion Both vHIT and CT can effectively evaluate the vestibular function of patients with AN(and they are complementary), and they are related to the size of the tumor and have certain value in the diagnosis of acoustic neuroma.
-
Key words:
- acoustic neuroma /
- video head impulse test /
- caloric test /
- magnetic resonance imaging
-
-
表 1 24例患者的临床资料
X ±S 临床资料 全部(24例) 肿瘤侧别 左侧 右侧 P值 男性/例(%) 12(50.0) 6(50.0) 6(50.0) > 0.99 年龄/岁 46.6±11.6 44.4±15.1 48.5±7.8 0.42 半规管轻瘫值/% 63.1±24.1 64.1±18.5 62.3±28.3 0.86 vHIT增益下降/例(%) 14(58.3) 6(54.5) 8(61.5) > 0.99 肿瘤大小/mm 22.7±1.0 21.8±8.4 23.4±11.5 0.7 DHI评分 8.9±16.2 7.5±11.8 10.2±19.6 0.69 
下载: 导出CSV
-
[1] Carlson M L, Link M J. Vestibular Schwannomas[J]. N Engl J Med, 2021, 384(14): 1335-1348. doi: 10.1056/NEJMra2020394
[2] Brodhun M, Stahn V, Harder A. [Pathogenesis and molecular pathology of vestibular schwannoma][J]. HNO, 2017, 65(5): 362-372. doi: 10.1007/s00106-016-0201-3
[3] Gianoli GJ, Soileau JS. Acoustic neuroma neurophysiologic correlates: vestibular-preoperative, intraoperative, and postoperative[J]. Otolaryngol Clin North Am, 2012, 45(2): 307-314. doi: 10.1016/j.otc.2011.12.004
[4] Tranter-Entwistle I, Dawes P, Darlington C L, et al. Video head impulse in comparison to caloric testing in unilateral vestibular schwannoma[J]. Acta Otolaryngol, 2016, 136(11): 1110-1114. doi: 10.1080/00016489.2016.1185540
[5] Tarnutzer AA, Bockisch CJ, Buffone E, et al. Pre-habilitation Before Vestibular Schwannoma Surgery-Impact of Intratympanal Gentamicin Application on the Vestibulo-Ocular Reflex[J]. Front Neurol, 2021, 12: 633356. doi: 10.3389/fneur.2021.633356
[6] Tarnutzer AA, Bockisch CJ, Buffone E, et al. Association of posterior semicircular canal hypofunction on video-head-impulse testing with other vestibulo-cochlear deficits[J]. Clin Neurophysiol, 2017, 128(8): 1532-1541. doi: 10.1016/j.clinph.2017.04.029
[7] Lee IS, Park HJ, Shin JE, et al. Results of air caloric and other vestibular tests in patients with chronic otitis media[J]. Clin Exp Otorhinolaryngol, 2009, 2(3): 145-150. doi: 10.3342/ceo.2009.2.3.145
[8] 刘嘉, 胡亚, 汪芹, 等. 视频头脉冲试验和冷热试验对前庭疾病评估相关性及差异性分析[J]. 临床耳鼻咽喉头颈外科杂志, 2021, 35(9): 802-806. https://d.wanfangdata.com.cn/periodical/lcebyhkzz202109007
[9] Kim G, Seo J, Lee S, et al. Therapeutic effect of steroids on vestibular neuritis: Systematic review and meta-analysis[J]. Clinical otolaryngology, 2022, 47(1): 34-43. doi: 10.1111/coa.13880
[10] Blodow A, Blodow J, Bloching MB, et al. Horizontal VOR function shows frequency dynamics in vestibular schwannoma[J]. Eur Arch Otorhinolaryngol, 2015, 272(9): 2143-2148. doi: 10.1007/s00405-014-3042-2
[11] Stevens MN, Garrison DB, Kaylie DM. What is the potential clinical utility of vHIT when assessing adult patients with dizziness?[J]. Laryngoscope, 2017, 127(12): 2689-2690. doi: 10.1002/lary.26774
[12] West N, Sass H, Klokker M, et al. Video Head Impulse Test Results in Patients With a Vestibular Schwannoma-Sensitivity and Correlation With Other Vestibular System Function Tests, Hearing Acuity, and Tumor Size[J]. Otol Neurotol, 2020, 41(5): e623-e629. doi: 10.1097/MAO.0000000000002600
[13] Batuecas-Caletrio A, Santacruz-Ruiz S, Munoz-Herrera A, et al. Vestibular compensation after vestibular schwannoma surgery: normalization of the subjective visual vertical and disability[J]. Acta Otolaryngol, 2013, 133(5): 475-480. doi: 10.3109/00016489.2012.757798
[14] 邹世桢, 李进让, 刘娅, 等. 视频头脉冲试验正常人群增益值年龄稳定性的临床研究[J]. 临床耳鼻咽喉头颈外科杂志, 2019, 33(5): 393-397. https://www.cnki.com.cn/Article/CJFDTOTAL-LCEH201905003.htm
[15] 王雯, 杨月嫦, 庄建华, 等. 前庭性偏头痛与前庭神经炎患者的变温试验及视频头脉冲试验结果差异分析[J]. 临床耳鼻咽喉头颈外科杂志, 2018, 32(9): 647-652. https://www.cnki.com.cn/Article/CJFDTOTAL-LCEH201809002.htm
[16] Ayas M, AlAmadi A. Emerging and distinct video head impulse test responses in elderly with vestibular symptoms[J]. Braz J Otorhinolaryngol, 2021, S1808-8694(21)00056-2.
[17] 张燕梅, 陈斯琦, 钟贞, 等. 视频头脉冲试验在眩晕疾病诊断中的初步应用[J]. 临床耳鼻咽喉头颈外科杂志, 2015, 29(12): 1053-1058. https://www.cnki.com.cn/Article/CJFDTOTAL-LCEH201512001.htm
[18] Smith PF. Why the cerebellar shutdown/clampdown hypothesis of vestibular compensation is inconsistent with neurophysiological evidence[J]. J Vestib Res, 2020, 30(5): 295-303. doi: 10.3233/VES-200715
[19] Yip CW, Strupp M. The Dizziness Handicap Inventory does not correlate with vestibular function tests: a prospective study[J]. J Neurol, 2018, 265(5): 1210-1218.
[20] Chari DA, Liu YH, Chung JJ, et al. Subjective Cognitive Symptoms and Dizziness Handicap Inventory(DHI)Performance in Patients With Vestibular Migraine and Menière's Disease[J]. Otol Neurotol, 2021, 42(6): 883-889.
-
图(2)
表(1)
计量
- 文章访问数: 1630
- PDF下载数: 233
- 施引文献: 0