ISSN 1673-3770 CN 37-1437/R
Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2021, Vol. 35 ›› Issue (6): 101-107.doi: 10.6040/j.issn.1673-3770.0.2020.504
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ZHANG Yaoyao,WANG Haitao
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| [1] 梅尼埃病诊断和治疗指南(2017)[C].中国中西医结合学会.中国中西医结合学会眩晕病专业委员会第二次学术大会暨河南省中西医结合学会眩晕病专业委员会第三次学术大会暨眩晕高峰论坛论文汇编.中国中西医结合学会,2017:111-117. [2] Neuhauser H, Leopold M, von Brevern M, et al. The interrelations of migraine, vertigo, and migrainous Vertigo[J]. Neurology, 2001, 56(4): 436-441. doi:10.1212/wnl.56.4.436. [3] 韩永平, 张俊义, 高霞, 等. 1.5T MRI条件钆造影在梅尼埃病患者中的临床应用[J]. 中华耳科学杂志, 2019, 17(6): 833-837. doi:10.3969/j.issn.1672-2922.2019.06.006. HAN Yongping, ZHANG Junyi, GAO Xia, et al. Clinical application of gadolinium angiography in patients with meniere disease under the condition of 1.5T MRI[J]. Chin J Otol, 2019, 17(6): 833-837. doi:10.3969/j.issn.1672-2922.2019.06.006. [4] Naganawa S, Satake H, Kawamura M, et al. Separate visualization of endolymphatic space, perilymphatic space and bone by a single pulse sequence; 3D-inversion recovery imaging utilizing real reconstruction after intratympanic Gd-DTPA administration at 3 Tesla[J]. Eur Radiol, 2008, 18(5): 920-924. doi:10.1007/s00330-008-0854-8. 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| [1] | XU Jia, LI Xin, CHEN Wenjing, GAO Juanjuan, LU Xingxing, YI Haijin. Short-term and long-term outcomes of endolymphatic sac decompression with instillation of local steroids for intractable Meniere's disease [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(4): 17-21. |
| [2] | JIANG Lina, YU Qianru, YU Jie, GUAN Benling, LU Yu, YU Shudong. Anxiety and depression in patients with common types of vertigo [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(6): 1-5. |
| [3] | Vertigo is one of the most important symptom of peripheral vestibular diseases which are difficult to differentially diagnose and manage because multiple disciplines are involved. The premise of effective management is accurate diagnosis of vestibular diseases. With the development of vestibular function examination technology and the deepening of vestibular disease research, great progress has been made in the diagnosis and management of vestibular diseases. The establishment and publication of international classification of vestibular diseases, the introduction of diagnostic standards for various vestibular diseases in the world, the formulation of vestibular disease drugs, surgical specifications and the rapid development of vestibular rehabilitation technology make the diagnosis and management of vestibular diseases more and more standardized and accurate.. Diagnosis and management of peripheral vestibular diseases [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(5): 1-6. |
| [4] | To establish a new grade of vestibular function abnormality in patients with Menieres disease(MD)and to preliminarily investigate its clinical significance and correlation with the hearing stage. MethodsClinical data of patients with unilateral intractable MD hospitalized from January to December were retrospectively reviewed. All patients underwent pure-tone audiometry, cervical vestibular-evoked myogenic potential(cVEMP)testing, ocular VEMP(oVEMP)testing, the video head impulse test(vHIT), and the caloric test. Abnormal semicircular canal function was defined as an abnormal vHIT or caloric test result. Abnormal saccule function was defined as an abnormal cVEMP. Abnormal utricle function was defined as an abnormal oVEMP. Vestibular function grade Ⅰ was defined when the utricle, saccule, and semicircular canal were normal. Vestibular function grade Ⅱ was defined when the utricle, saccule, or semicircular canal was abnormal. Vestibular function grade Ⅲ was defined when two structures among the utricle, saccule, and semicircular canal were abnormal. Finally, vestibular function grade Ⅳ was defined when the utricle, saccule, and semicircular canal were all abnormal. ResultsWe enrolled cases of MD, including , , , and cases in stages Ⅰ, Ⅱ, Ⅲ, and Ⅳ, respectively. The pure-tone average(PTA)hearing at Hz, kHz, and kHz was .±. dB HL in the ears with MD. The abnormal rates of cVEMP, oVEMP, vHIT, and caloric test results were .%, .%, .%, and .%, respectively. According to the grade of vestibular function abnormality, , , , and cases were in grades Ⅰ, Ⅱ, Ⅲ, and Ⅳ, respectively. The vestibular function stage significantly correlated with the PTA(Pr=.), MD stage(P., r=.), and disease duration(P=., r=.). The vestibular function stage did not significantly correlate with patient age(P=.). ConclusionThe rates of abnormal otolith and semicircular canal functions increase with the development of MD. Therefore, patients with MD can be accurately assessed with precise testing of the utricle, saccule, and semicircular canals. The status of the development of MD is reflected in the hearing and vestibular function stages. The combined assessment of hearing and vestibular functions can provide a useful reference for the treatment and prognosis of patients with MD.. A new grade of vestibular function abnormality in Menieres disease: a pilot study [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(5): 14-19. |
| [5] | This study was designed to evaluate the diagnostic value of extra-tympanic electrocochleography(ET-ECochG)in definite Ménières disease(MD)patients. MethodsFifty-eight definite MD patients( ears)underwent ET-ECochG using bronze foil electrodes. The medical history, as well as pure tone audiometry, ET-ECochG, and D FLAIR MRI data of each patient were collected. Meanwhile, forty healthy volunteers were enrolled as controls. The amplitudes, latencies, and durations of SP and AP, the SP/AP amplitude ratio(SP/AP), and the area ratio of SP/AP(Asp/Aap)were collected. An adjusted calculation method for Asp/Aap was proposed. The differences among the ET-ECochG results of the definite MD ears, contralateral asymptomatic ears, and normal ears were analyzed using the t-test and the Mann-Whitney U test. The associations of Asp/Aap of ET-ECochG with the clinical history, pure tone audiometry, and endolymphatic hydrops evaluated via MRI were analyzed. ResultsET-ECochG was identified in of ears(.%). Using the receiver operating characteristic(ROC)curve, the optimal cutoff points of SP/AP and Asp/Aap were . and ., respectively. The area under the ROC curve(AUC)of Asp/Aap(.)was higher than the AUC of SP/AP(.). The ET-ECochG results of the definite MD ears, including SP/AP, Asp/Aap, and SP duration, were significantly higher than those of the contralateral asymptomatic ears and normal ears(p<.). The duration and disease. Diagnostic value of electrocochleography using external auditory canal electrode in patients with Menieres disease [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(5): 20-26. |
| [6] | To determine the therapeutic effectiveness of retrolabyrinthine vestibular neurectomy for intractable Menieres disease.MethodsClinical data of patients with unilateral intractable Menieres disease who underwent retrolabyrinthine vestibular neurectomy were retrospectively investigated. Therapeutic effectiveness was analyzed, and the safety and reliability of the procedure was discussed. ResultsThe mean duration of the disease was .±. months. Preoperative pure tone average of Hz, Hz, Hz, and Hz was(.±.)dB HL. Two cases were stage Ⅱ, cases were stage Ⅲ, and cases were stage Ⅳ. Two stage Ⅱ patients were recurrent cases after endolymphatic sac decompression surgery. Intracranial infection in case(.%), cerebrospinal fluid leakage in cases(.%), temporal facial nerve palsy in case(.%), incision infection in cases(.%), and fat liquefaction in cases(.%)were observed postoperatively. There was no case of intracranial hemorrhage or total deafness. Therapeutic effectiveness for relieving vertigo was level A in cases and level B in cases. ConclusionThe therapeutic effectiveness of retrolabyrinthine vestibular neurectomy for intractable Menieres disease is definite. Surgical risk and postoperative complications are controllable, and the quality of life can be significantly improved after surgery.. Therapeutic effectiveness of 75 cases of retrolabyrinthine vestibular neurectomy for intractable Menieres disease [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(5): 46-50. |
| [7] | This study aimed to compare the abnormality rate of vestibular evoked myogenic potentials(VEMPs)in patients with primary and recurrent benign paroxysmal positional vertigo(BPPV)and test the hypothesis that otolith dysfunction causes the recurrence of BPPV. MethodsCervical VEMP(cVEMP)and ocular VEMP(oVEMP)tests using air-conducted 500 Hz tone-burst stimuli were performed on 57 patients with unilateral primary BPPV(n=36)and recurrent BPPV(n=21)between June 2019 and May 2020. Abnormalities in cVEMP and oVEMP were compared between the primary and recurrent BPPV groups. Results(1) The differences in sex, the involved side, and canal between the primary and recurrent BPPV groups were not significant; however, the difference was statistically significant in terms of age; (2) Of the 57 BPPV patients, cVEMP or oVEMP was not elicited in 21 cases(36.84%)and 35 cases(61.40%), respectively. The abnormality rate of oVEMP was much higher(P<0.05); (3)Abnormal cVEMP was observed in 16 of 36(44.45%)and 5 of 21(23.81%)cases in the primary and recurrent BPPV groups, respectively. Abnormal oVMEP was observed in 19 of 36(52.79%)and 16 in 21(76.19%)patients in the primary and recurrent BPPV groups, respectively. Differences in the abnormality rates of cVMEP and oVMEP were not found between the primary and recurrent BPPV groups(P>0.05); (4) When the recurrent BPPV group was further divided into 2-times groups and ≥3-times group according to the recurrent frequency, there were also no statistical differences in the VEMP abnormality rate in these three groups(P>0.05). ConclusionThe results showed no significant difference in the abnormality rate of cVEMP and oVEMP between the primary BPPV and recurrent BPPV groups, indicating that the possible recurrent mechanism of primary BPPV still needs to be further studied.. Abnormality rate of vestibular evoked myogenic potentials in patients with primary and recurrent benign paroxysmal positional vertigo: a clinical observation [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(5): 51-55. |
| [8] | To explore the relationship between dizziness-vertigo and nystagmus intensity, according to the nystagmus accompanied by dizziness and/or vertigo during caloric test. MethodsThe relationship between dizziness and vertigo sensations and nystagmus intensity was analyzed in 399 patients with peripheral vestibular disorders,who underwent routine caloric test. The nystagmus intensity is as an index, accompanied by dizziness and/or vertigo sensations induced during caloric test. ResultsWarm and cold stimulation induced dizziness and vertigo and associated nystagmus overall analysis, the intensity of nystagmus was always greater than that of dizziness when vertigo occurred. The nystagmus thresholds for dizziness and vertigo induced by warm and cold air stimulation in the left ears were 4.2°/s and 5.9°/s for cold, 4.2°/s and 8°/s for warm, in the right ears were 4.6°/s and 6.2°/s for cold, 5.3°/s and 6.5°/s for warm, respectively. Three hundred ninety nine patients were subjected to alternating warm and cold stimulation in both ears for a total of 1596 times, which induced dizziness 513 times(32.14%), of which 312 times only dizziness and 201 times vertigo ten seconds after dizziness. Vertigo was induced 906 times(56.77%), of which 705 occurred directly without transitioning from dizziness to vertigo, and another 201 times vertigo occurred after ten seconds of dizziness; 378(23.68%)times did not induce dizziness and vertigo. ConclusionsVertigo corresponds to a higher nystagmus intensity threshold than dizziness, with patients showing dizziness when the nystagmus is weak and vertigo when it is stronger. Warm and cold air stimulation induced nystagmus intensity from weak to strong, and from dizziness to vertigo sensations induced at the same time, suggesting that the symptoms of dizziness and vertigo are related to the asymmetric between the two vestibular tension.. Study of the relationship of dizziness and vertigo sensations with the nystagmus intensity [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(5): 56-60. |
| [9] | To analyze the possible causes of poor development of imaging in patients undergoing three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging(3D-FLAIR MRI)after intratympanic gadolinium injection in our hospital in recent years and propose possible solutions. MethodsThis study enrolled a total of 356 patients and 706 ears between January 2017 and June 2020. All patients underwent 3D-FLAIR MRI through intratympanic gadolinium injection. The imaging was poorly developed for a total of 55 patients(70 ears). The possible causes of poor development were analyzed. ResultsPoor images was obtained in 70 ears, including 16 instances in which the signal was not as strong as normal, 14 that were not filled contiguously, and 40 that showed no contrast agent in the inner ear on imaging. A total of 39 ears had simple ipsilateral otitis media as revealed by imaging; among those with chronic otitis media or occult otitis media, 11 showed poor visualization(28.2%). Imaging was poor for four(12.5%)out of 32 ears with sinusitis. Among the three ears with both otitis media and sinusitis, imaging was poor for one ear(33.3%). Among the 632 ears without otitis media/sinusitis, imaging was poor for only 54 ears(8.5%). A statistically significant difference was observed between combined and non-combined otitis media, but not between those non-combined,combined rhinosinusitis, as sell as those conbined with otitis media and nasosinusitis. ConclusionWhen gadolinium is injected into the inner ear through the tympanum, though excluding a recent history of otitis media, chronic or occult otitis media may still be influencing factors for poor imaging development. The present article further discusses other possible influencing factors in each link of angiography and suggests avoiding them to improve the success rate of inner ear gadolinium angiography.. A preliminary study on the causes of poor development in three-dimensional magnetic resonance imaging via intratympanic gadolinium injection [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(5): 61-66. |
| [10] | Vestibular rehabilitation training is important for treating vestibular diseases and improving vertigo symptoms. However, the large number of patients, the lack of venues and rehabilitation specialists, and medical expenses have limited its application at all levels in hospitals. With the development of smartphones and the mobile internet, home-based rehabilitation and remote guidance have become possible. Therefore, we developed a remote vestibular rehabilitation training guidance platform to be accessed with smartphones and the mobile internet. The platform design is based on the Browser/Server mode structure; it has IOS and Android versions and supports wireless access smartphone terminals. The platform facilitates a more convenient, smooth, and effective remote guidance for vestibular rehabilitation function exercises, curative effect evaluations, and follow-up; this improves efficiency and compliance as well as reduces the technical barriers, site restrictions, and labor costs of vestibular rehabilitation. This paper introduces the functional design, related technology realization, and the operational effect of the platform.. Development and application of a vestibular rehabilitation training guidance platform [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(5): 78-81. |
| [11] | Sudden sensorineural hearing loss(SSNHL)is defined as a decease in hearing ≥30 dB HL affecting at least three consecutive frequencies with no identifiable cause within 72 h. A possible cause is inner ear hemorrhage. However, detecting inner ear hemorrhage is difficult with conventional magnetic resonance imaging(MRI)sequences. Some studies showed that the 3-dimensional fluid attenuated inversion recovery(3D-FLAIR)MRI sequence could sensitively detect inner ear hemorrhage in SSNHL patients. In this article, we review the related literature about the clinical application of the 3D-FLAIR MRI sequence to evaluate SSNHL caused by inner ear hemorrhage.. The role of three-dimensional fluid attenuated inversion recovery magnetic resonance imaging in diagnosis of sudden sensorineural hearing loss caused by inner ear hemorrhage [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(5): 97-101. |
| [12] | Labyrinthitis is an infectious disease of the inner ear. Its main clinical manifestations are paroxysmal dizziness, vertigo, and sensorineural hearing loss. This article focuses on the otogenic bacterial labyrinthitis associated with otitis media. According to the pathological manifestations of the inner ear, labyrinthitis can be divided into three types: circumscribed labyrinthitis, serous labyrinthitis, and suppurative labyrinthitis. Circumscribed labyrinthitis, also known as labyrinth fistula, is often complicated by middle ear cholesteatoma, which usually occurs in the horizontal semicircular canal. Serous labyrinthitis is a sterile inflammation in the inner ear caused by bacterial toxins, which often leads to misdiagnosis and misjudgment. Suppurative labyrinthitis is a bacterial infectious inflammation that occurs in the inner ear that often causes severe sensorineural hearing loss and dizziness. At present, otogenic labyrinthitis is no longer rare, although it has not attracted enough attention. This article reviews the different types of otogenic bacterial labyrinthitis in a combination of domestic and foreign literature to provide clinical help for early diagnosis and treatment of patients with this condition.. The progress of otogenic bacterial labyrinthitis research [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(5): 102-107. |
| [13] | Benign paroxysmal positional vertigo(BPPV), the most common peripheral vestibular disease, has a high incidence and prevalence. It mostly occurs at night or during morning awakening, suggesting that it is closely related to sleep characteristics. We reviewed and summarized the relevant literature of the two diseases in recent years. We found that sleep posture was closely related to the occurrence, development, treatment, and prognosis of BPPV, and that different types of sleep disorders also individually affected the occurrence of the disease. This article was aimed to help raise awareness regarding the correlation between the two diseases as well as provide methods and ideas for the diagnosis and treatment.. Research progress on the effect of sleep on benign paroxysmal positional vertigo [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(5): 108-112. |
| [14] | Haijin YI,Shiming YANG. Value the diagnosis and treatment of ear trauma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(1): 1-3. |
| [15] | Jia XU,Haijin YI. Standardized treatment of auricular complications with temporal bone fractures [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(1): 4-8. |
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