良性阵发性位置性眩晕患者耳石复位前后主观视觉垂直线的变化

李培鸿; 刘强; 王巍; 陈太生

doi:10.13201/j.issn.2096-7993.2022.11.002

良性阵发性位置性眩晕患者耳石复位前后主观视觉垂直线的变化

- 天津市第一中心医院耳鼻咽喉头颈外科天津市耳鼻喉科研究所天津市听觉言语与平衡医学重点实验室天津市医学重点学科(耳鼻咽喉科学) 天津市耳鼻喉质量控制中心(天津，300192)

详细信息

通讯作者: 陈太生，E-mail：cts501@sina.com

中图分类号: R764.3

收稿日期: 2022-06-10

刊出日期: 2022-11-03

The changes in subjective visual vertical after otolith reduction in patients with BPPV

- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital; Institute of Otolaryngology of Tianjin; Key Laboratory of Auditory Speech and Balance Medicine, Tianjin; Key Medical Discipline of Tianjin[Otolaryngology]; Quality Control Centre of Otolaryngology, Tianjin, 300192, China

More Information

Corresponding author: CHEN Taisheng, E-mail: cts501@sina.com

Received Date: 10 June 2022

Publish Date: 03 November 2022

摘要

摘要: 目的观察分析良性阵发性位置性眩晕(BPPV)患者耳石复位后主观视觉垂直线(SVV)的变化特点。方法选取确诊BPPV且耳石复位成功的46例患者为试验组(后半规管BPPV管石症31例、水平半规管BPPV管石症15例，右耳29例、左耳17例)，健康青年志愿者50例为对照组。利用虚拟现实SVV检查系统，分别对试验组患者耳石复位前后和对照组进行正头位0° SVV检测，分析试验组患者耳石复位前后SVV的偏斜角度。结果对照组的SVV为(-1.57±2.28)°; 试验组右耳及左耳BPPV患者复位前的SVV分别为(0.08±3.83)°和(-1.69±2.23)°，复位后的SVV分别为(-1.52±3.74)°和(-1.04±2.50)°。组间分析，仅右耳BPPV复位前与对照组、右耳BPPV复位前后的SVV偏斜角度的差异有统计学意义。试验组耳石复位后18例偏斜角度变大，28例偏斜角度变小，其中偏斜角度变小甚至转向对侧偏斜的有13例。结论BPPV患者椭圆囊功能障碍导致对重力垂直线的判断误差，复位耳石可对椭圆囊产生新刺激、影响其功能状态，SVV检测可为BPPV患者的椭圆囊功能评估提供帮助。
- 眩晕 /
- 主观视觉垂直线 /
- 椭圆囊
Abstract: ObjectiveTo observe and analyze the changes in subjective visual vertical(SVV) after otolith reduction in patients with BPPV.Methods46 patients with confirmed BPPV recieving successful otolith reduction were selected as the test group. 31 cases of posterior canal stones and 15 cases of horizontal semicircular canal stones, 29 cases of right ear and 17 cases of left ear. Fifty cases of healthy young volunteers were in the control group. Using the virtual reality SVV examination system, 0° SVV in the positive head were tested in the test group patients before and after the reduction of SVV, and were tested in the control group.The deviation angle of the SVV before and after the otolith reduction in the test group were analyzed.ResultsBefore otoliths reduction, the SVV was (0.08±3.83)° of right BPPV and was (-1.69±2.23)° of left BPPV. After otoliths reduction, the SVV was (-1.52±3.74)° of right BPPV and was (-1.04±2.50)° of left BPPV. In the control group, the SVV was(-1.57±2.28)°. The changes of SVV deflection angle between the control group and the right BPPV before the otolith reduction, and before and after the otolith reduction in the right BPPV were analyzed, and the differences were all statistically significant. There was no significant difference in SVV deflection angle between the left BPPV(before and after reduction) and the control group. In the test group, after the otolith reduction, 18 cases had larger bias angles, 28 cases had smaller bias angle among which 13 cases the deviation angle even turned to the contralateral side.ConclusionUtriculare dysfunction in patients with BPPV leads to the judgment error of SVV. Reduction of otolithoid can cause new stimulation to the eutricule and affect its functional status. SVV detection can provide help for the evaluation of utricular function in patients with BPPV.
- vertigo /
- subjective visual vertical /
- utricle

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图 1 SVV检测时受检者视野及操作情况

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图 2 SVV检测计算机控制界面及输出报告单

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图 3 试验组耳石复位前后及对照组SVV的偏斜角度

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图 4 试验组耳石复位前后及对照组SVV的偏斜角度散点图

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图 5 有、无残余症状组复位前后及对照组SVV的偏斜角度

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图 6 有、无残余症状组复位前后及对照组SVV的偏斜角度散点图

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表 1 有残余症状组和无残余症状组复位前后的SVV与对照组比较

组别	SVV偏斜角度/(°)	P值
对照组	-1.57±2.28
无残余症状组
复位前	-0.61±3.46	0.17
复位后	-0.84±3.40	0.29
有残余症状组
复位前	-0.50±3.42	0.23
复位后	-2.40±2.96	0.35
注：P值为不同组别SVV偏斜角度与对照组比较。

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