An analyzation on the characterization of frequency tuning of vestibular evoked myogenic potential in patients with unilateral vestibular hypofunction
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摘要: 目的 探讨增加1 kHz颈肌前庭诱发肌源性电位(cVEMP)及眼肌前庭诱发肌源性电位(oVEMP)测试在单侧前庭功能低下疾病辅助诊断中的价值。方法 回顾分析84例诊断明确且有两项或以上前庭功能检测结果为单侧前庭功能低下患者的资料，其中单侧梅尼埃病29例、良性阵发性位置性眩晕(BPPV)27例、特发性突发性感音神经性聋(ISSHL)伴眩晕8例，ISSHL不伴眩晕20例。应用SPSS 25.0软件进行统计分析，观察不同疾病组中功能低下侧与对照侧cVEMP及oVEMP的500 Hz/1 kHz频率振幅比(FAR)差异。结果 ① 500 Hz和1 kHz的cVEMP引出率分别为95.24%(80/84)和98.81%(83/84)；500 Hz和1 kHz的oVEMP引出率分别为78.57%(66/84)和91.67%(77/84)。②除在后半规管BPPV组的oVEMP以及在水平半规管BPPV组的cVEMP观察到FAR的侧别差异(P < 0.05)外，其余疾病组均未观察到显著的侧别差异(P>0.05)。结论 在单侧前庭功能低下患者中，cVEMP和oVEMP在不同受累半规管BPPV患者中有不同的频率调谐现象。增加1 kHz cVEMP和oVEMP作为常规刺激声频率应用于临床，对于患侧的判断及不同半规管受累的BPPV诊疗及预后具有一定的临床参考意义。Abstract: Objective To explore the value of adding 1 kHz cervical vestibular evoked myogenic potential(cVEMP) and ocular vestibular evoked myogenic potential(oVEMP) in the auxiliary diagnosis of unilateral vestibular hypofunction.Methods A retrospective analysis of 84 patients with unilateral vestibular hypofunction receiving two or more vestibular function tests was conducted, 29 cases of unilateral Ménière's disease, 27 cases of benign paroxysmal positional vertigo (BPPV), 8 cases of idiopathic sudden sensorineural hearing loss (ISSHL) with vertigo, and 20 cases of ISSHL without vertigo were included. SPSS 25.0 software was used for statistical analysis to observe the difference of frequency amplitude ratio (FAR) at 500 Hz/1 kHz of cVEMP and oVEMP between the experimental and control groups.Results ① The cVEMP elicitation rates were 95.24% (80/84) and 98.81% (83/84) for 500 Hz and 1 kHz, respectively; and the oVEMP elicitation rates were 78.57% (66/84) and 91.67% (77/84) for 500 Hz and 1 kHz, respectively. ②Except for the lateral difference of FAR in oVEMP of the posterior semicircular canal BPPV group and cVEMP of the horizontal semicircular canal BPPV group (P < 0.05), no significant lateral difference was observed in the other disease groups (P>0.05).Conclusion In patients with unilateral vestibular hypofunction, cVEMP and oVEMP showed different frequency tuning changes in different semicircular canal BPPV groups. Additionally, 1 kHz cVEMP and oVEMP as regular stimulation frequencies in clinical test, which has certain clinical reference significance for determining the diagnosis and prognosis of BPPV on the weak ear and in different semicircular canal involvement.
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