前庭诱发的肌源性电位阈值检测的临床应用

VEMP threshold measurements and clinical application

目的探讨前庭诱发的肌源性电位（vestibular evoked myogenic potential,VEMP）的临床诊断价值。方法分别检测一组正常人和膜迷路积水、镫骨足板活动过度和上半规管裂等三种疾病的VEMP阈值,用以判断VEMP的正常阈值以及变化。结果正常人VEMP阈值为80-100dBnHL,平均为（85.7±5.1）dB（n=21）。三种疾病：膜迷路积水、镫骨足板活动过度和上半规管裂均可出现VEMP阈值降低的现象。结论上半规管裂时内耳和周围结构之间存在异常交通,膜迷路积水和镫骨足板活动过度则可能系球囊与镫骨足板之间的距离变近,可出现对声音或压力敏感性眩晕。VEMP阈值的变化可以对这类眩晕进行客观评价。

Objective To explore the significance of the threshold of vestibular evoked myogenic potentials（VEMP） on diagnosis of pressure or sound sensitive vertigo. Methods The thresholds of VEMP were determined in a group of normal subjects and 6 patients with pressure or sound sensitive vertigo. Results The thresholds of VEMP in normal subjects were between 80 - 100 dB, averaged 85.7 ＋ 5.1 dB（n = 21 ）,whereas in the three kinds of inner ear abnormalities, the threshold of VEMP dropped beyond the normative mean in the normal subjects. Conclusion Pressure or sound sensitive vertigo seemed to occur when there were abnormal communication between the inner ear and surrounding structures or the shortend distance between the footplate and saccule. The threshold change of VEMP could act as a objective evaluation method for these conditions.