山东大学耳鼻喉眼学报 ›› 2020, Vol. 34 ›› Issue (5): 39-45.doi: 10.6040/j.issn.1673-3770.1.2020.064

• 临床研究 • 上一篇    下一篇

非综合征型听神经病患者前庭上下成分功能障碍定位研究与频率特征

胡娟1,陈耔辰1,陈飞云1,张玉忠1,魏馨雨1,赵欢娣1,史文迪2,杨军3,张青1,3   

  1. 胡娟1, 陈耔辰1, 陈飞云1, 张玉忠1, 魏馨雨1, 赵欢娣1, 史文迪2, 杨军3, 张青1, 31. 西安交通大学第二附属医院 耳鼻咽喉头颈外科, 陕西 西安 710004;
    2. 杭州仁爱耳聋康复研究院临床听力学研究所, 浙江 杭州 310042;
    3. 上海交通大学医学院附属新华医院 耳鼻咽喉头颈外科/上海交通大学医学院耳科学研究所/上海市耳鼻疾病转化医学重点实验室, 上海 200092
  • 收稿日期:2020-07-03 出版日期:2020-09-20 发布日期:2020-11-17
  • 基金资助:
    国家自然科学基金(81600809,81670945,81970891);陕西省自然科学基础研究计划(2018JQ8001,2020KWZ-019);中央高校基本科研业务费(xjj2018279);西安交通大学第二附属医院人才培养专项科研基金[RC(GG)201802]

Location and frequency characteristics of vestibular dysfunction in patients with nonsyndromic auditory neuropathy

This study was aimed at determining vestibular involvement and the location and frequency of vestibular dysfunction in patients with auditory neuropathy. MethodsTwenty patients with non-syndromic auditory neuropathy were enrolled. Using vestibular test battery, we calculated the ocular vestibular-evoked myogenic potential(oVEMP), cervical vestibular-evoked myogenic potential(cVEMP), video head impulse test(vHIT), suppression head impulse paradigm(SHIMP), and caloric test results. ResultsThe oVEMP and cVEMP were calculated for all patients, and the abnormality rates were 85% and 95%, respectively, showing no significant difference. The vHIT in the lateral, anterior, and posterior semicircular canals, and SHIMP in the lateral canals were calculated for 11 patients(22 ears), and the abnormality rates were 14%, 18%, 9%, and 9%, respectively, showing no significant difference among the four tests. Nineteen patients exhibited a 74% abnormality rate for the caloric test. Of the 11 patients with the SHIMP and vHIT results, 82% showed abnormal caloric test results, which was much higher than the abnormality rate of SHIMP and vHIT. ConclusionPatients with auditory neuropathy showed vestibular involvement, and the superior and inferior vestibular components, including the vestibular peripheral receptors and nerves, had an equal probability of dysfunction. All the otolith organs and semicircular canals could be involved. The possibility of dysfunction was equal for different portions of the semicircular canal, while the functional involvement was more likely to be observed in low-frequency tests.   

  1. Key words: Nonsyndromic;
    Auditory neuropathy;
    Vestibular function;
    Location;
    Frequency
  • Received:2020-07-03 Online:2020-09-20 Published:2020-11-17

摘要: 目的 探讨听神经病伴发前庭功能障碍的可能性,并分析其部位和频率特征。 方法 以眼肌前庭诱发肌源性电位(oVEMP)、颈肌前庭诱发肌源性电位(cVEMP)、视频头脉冲试验(vHIT)、头脉冲抑制试验(SHIMP)和冷热试验对20例(40耳)非综合征型听神经病患者进行前庭功能评估,对统计学处理结果进行客观分析。 结果 20例患者(40耳)接受oVEMP和cVEMP测试,oVEMP异常率为85%,cVEMP异常率为95%,差异无统计学意义。11例(22耳)接受vHIT和SHIMP测试,外、上、后半规管vHIT和SHIMP的异常率分别为14%、18%、9%和9%,组间差异无统计学意义。19例患者行冷热试验,异常率为74%。11例接受vHIT和SHIMP测试的患者,冷热试验异常率为82%,显著高于vHIT和SHIMP异常率,差异有统计学意义。 结论 听神经病患者存在前庭功能障碍,前庭上下成分(包括感受器和前庭上下神经)受累概率相当,耳石器和半规管均可受累,各半规管受累概率相当,半规管功能损伤主要累及低频。

关键词: 非综合征型, 听神经病, 前庭功能, 定位, 频率

Abstract: Objectives This study was aimed at determining vestibular involvement and the location and frequency of vestibular dysfunction in patients with auditory neuropathy. Methods Twenty patients with non-syndromic auditory neuropathy were enrolled. Using vestibular test battery, we calculated the ocular vestibular-evoked myogenic potential(oVEMP), cervical vestibular-evoked myogenic potential(cVEMP), video head impulse test(vHIT), suppression head impulse paradigm(SHIMP), and caloric test results. Results The oVEMP and cVEMP were calculated for all patients, and the abnormality rates were 85% and 95%, respectively, showing no significant difference. The vHIT in the lateral, anterior, and posterior semicircular canals, and SHIMP in the lateral canals were calculated for 11 patients(22 ears), and the abnormality rates were 14%, 18%, 9%, and 9%, respectively, showing no significant difference among the four tests. Nineteen patients exhibited a 74% abnormality rate for the caloric test. Of the 11 patients with the SHIMP and vHIT results, 82% showed abnormal caloric test results, which was much higher than the abnormality rate of SHIMP and vHIT. Conclusion Patients with auditory neuropathy showed vestibular involvement, and the superior and inferior vestibular components, including the vestibular peripheral receptors and nerves, had an equal probability of dysfunction. All the otolith organs and semicircular canals could be involved. The possibility of dysfunction was equal for different portions of the semicircular canal, while the functional involvement was more likely to be observed in low-frequency tests.

Key words: Nonsyndromic, Auditory neuropathy, Vestibular function, Location, Frequency

中图分类号: 

  • R764
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