旋转试验与冷热水试验检查前庭功能的结果比较(英文)

Rotation test versus water caloric test in the evaluation of the vestibular function

背景:判断前庭功能的方法有冷热试验及旋转试验,两种方法检测结果相关性如何?目的:观察旋转试验与冷热水试验检查前庭功能结果的一致性。设计:以患者为观察对象,评估方法学优异性的对比实验。单位:解放军总医院耳鼻咽喉科。对象:选择1990-04/1996-12在解放军总医院耳鼻咽喉科因眩晕、耳聋耳鸣就诊的门诊及病房患者为观察对象,所有患者均经用Hallpike冷热水试验检查结果均显示前庭功能异常,且知情同意。其中男68例,女32例;年龄16～74岁,平均(37±3)岁。单侧异常91例,双侧异常9例。前庭功能异常判定标准为[建侧眼震慢相角速度(slowphaseveloci-ty,SPV)-患侧SPV/健侧SPV-患侧SPVX100%]≥15%,上述比值<15%判定为正常。方法:对患者进行旋转试验,分别采用正弦摆动和旋转骤停两种刺激方式,其中正弦摆动试验刺激幅度为90°,频率为0.167Hz;骤停旋转试验,1°～2°/s2加速度达峰速90°/s,恒速旋转至眼震消失后骤停进行测试。主要观察指标:骤停旋转试验及正弦摆动试验结果。结果:按实际处理分析。双侧异常者9例,8例诱发出眼震,1例双侧听神经瘤旋转试验未诱发出眼震。其他患者旋转试验均诱发出眼震。冷热水试验单侧异常的91例患者中有2例由于不愿接受骤停旋转试验而未做。正弦摆动试验检查64%(58/91)患者前庭功能异常,骤停旋转试验检查61%(54/91)患者前庭功能异常。结论:旋转试验中的正弦摆动试验和骤停旋转试验可检查出前庭功能异常,但与冷热水试验结果不完全相符。

BACKGROUND:There are two methods to evaluate the vestibular function,the rota tion test and the water caloric test.What is the relativity between the test res ults with these two methods? OBJECTIVE:To observe the consistency between the vestibular functional evalua tions with the rotation test and the water caloric test. DESIGN:A comparative study on the advantage of the evaluation methodologies w ith patients as the objects. SETTING:Department of Otolaryngology of Chinese PLA General Hospital. PARTICIPANTS:The patients with vertigo,deafness and tinnitus were chosen,who were picked up in the inpatient department and outpatient department in the Otol aryngology Department of the Chinese PLA General Hospital from April 1990 to Dec ember 1996.With the permission, the vestibular functions of all the patients we re tested to be abnormal by the Hallpike caloric test.There were 68 males and 32 females,whose ages varied from 16 to 74,and the average age was 37± 3.There we re 91 cases with unilateral abnormality and 9 cases with bilateral abnormality.T he judging standard of the abnormal vestibular function is that slow phase veloc ity(SPV) of the nystagmus on the normal side- SPV on the abnormal side /SPV on the normal side- SPV on the abnormal side× 100% ]≥ 15% ,and the ratio METHODS:The rotation test was done to the patients with the sine swing stimul ation and rotation sudden pause stimulation respectively .The stimulation scope of the sine swing stimulation was 90° and the frequency was 0.167 Hz; In the r otation sudden pause test,when the peak velocity reached 90° /s at the accelera tion of 1° - 2° /s2,the velocity was maintained until the disappearance of t he nystagmus,then sudden pause was done for the further test. MAIN OUTCOME MEASURES:The results of the sine swing test and the rotation sud den pause test. RESULTS:According to the actual disposal,in the rotation test,there were 9 ca ses with bilateral abnormality,among them the nystagmus was induced in 8 cases a nd no nystagmus was induced in 1 case with bilateral acoustic neuroma,and in the other cases the nystagmus was induced.In the water caloric test,there were 91 c ases with unilateral abnormality,2 cases refused to take the rotation sudden pau se test.In the sine swing test,64% (58/91) cases had abnormal vestibular functi on,and in the rotation sudden pause test 61% (54/91) cases had abnormal vestibu lar function. CONCLUSION:The abnormality of the vestibular function can be found in the sin e swing test and the rotation sudden pause test of the rotation test,but the res ults do not completely conform to that in the water caloric test.