不伴眩晕的突发性感音神经性耳聋患者隐匿的前庭机能障碍研究

Vestibular Dysfunctionin Patients with Sudden Sensorineural Hearing Loss without Vertigo

中文关键词:  突聋 眩晕 前庭诱发肌源性电位 Caloric试验

英文关键词:Sudden hearing loss Vertigo Vestibular evoked myogenic potentials Caloric test

中文摘要:

      目的 观察不伴眩晕的突发性感音神经性耳聋（简称突聋）患者前庭机能及损伤范围。方法 选择不伴眩晕的单侧突聋患者42例（42耳），分别进行眼肌和颈肌前庭诱发肌源性电位（oVEMP，cVEMP）及Caloric试验；以伴眩晕的单侧突聋患者62例（62耳）及年龄和性别匹配的健康人25例（50耳）为对照，分析不伴眩晕的突聋患耳的前庭机能受损状况。结果 突聋不伴眩晕组患耳oVEMP、cVEMP的异常率为54.8%、52.4%，Caloric试验异常率52.4%；伴眩晕组患耳oVEMP、cVEMP异常率为64.5%、48.4%，Caloric试验异常率75.9%；正常对照组oVEMP、cVEMP异常率为26.0%、14.0%。突聋不伴眩晕组患耳较正常耳 oVEMP和cVEMP异常率高（P<0.01）；突聋不伴眩晕及伴眩晕组患耳oVEMP、cVEMP及Caloric试验异常率相当（P>0.05）。结论 不伴眩晕的突聋患耳可以伴有前庭机能受损，且受损几率与伴眩晕突聋患耳相当，是否伴有眩晕可能与前庭机能损害的程度和范围无关。

英文摘要:

      Objective To observe the vestibular dysfunction in sudden sensorineural hearing loss (SSHL) patients without vertigo. Methods Forty-two cases of unilateral SSHL without vertigo were enrolled in the study from May 2012 to May 2014. All patients underwent air conducted sound elicited oVEMP and cVEMP respectively. Some of them also received caloric test. Sixty-two SSHL patients with vertigo and twenty-five age-and gender-matched normal subjects were recruited as controls to analyze the vestibular dysfunction in SSHL patients without vertigo. Results Abnormal oVEMP was observed in 54.8% affected ears without vertigo (23/42), 64.5% ears with vertigo (40/62), and 26.0% normal ears (13/50). Abnormal cVEMP was observed in 52.4% affected ears without vertigo (22/42), 48.4% ears with vertigo (30/62), and 14.0% normal ears (7/50). Caloric test was operated in 21 SSHL patients without vertigo and 29 patients with vertigo. Abnormal caloric test was observed in 52.4% (11/21) SSHL patients without vertigo and 75.9% (22/29) SSHL patients with vertigo respectively. Statistical significance was found in oVEMP and cVEMP rates between SSHL without vertigo and normal group (P<0.01)．However, no significant statistical difference was found in oVEMP, cVEMP rates and caloric test between SSHL without vertigo and SSHL with vertigo group (P>0.05)． Conclusion Vestibular function could be damaged in SSHL patients without vertigo．The abnormal rates of oVEMP, cVEMP and caloric test in SSHL patients without vertigo were similar to that of SSHL patients with vertigo.The appearance of vertigo might be irrelevant to the range and extent of vestibular dysfunction.