水平半规管壶腹嵴帽结石症的诊断和治疗

Diagnosis and therapy for horizontal semicircular canal cupulolithiasis

目的:探讨水平半规管壶腹嵴帽结石症(HSC-Cup)的诊断和治疗。方法:回顾性分析36例HSCCup患者的临床资料,应用视频眼震图仪记录滚转试验诱发的眼震,比较各个试验头位的眼震方向、潜伏期、强度及持续时间,应用SPSS 17.0统计软件进行数据处理。对所有患者采取避免健侧卧位,高枕睡眠,白天避免甩头动作,并口服敏使朗治疗1周后的效果进行评估。结果:所有患者左、右转头均诱发出水平离地性眼震。眼震潜伏期:健侧、患侧分别为(0.93±0.65)s、(1.01±0.78)s,二者差异无统计学意义(P>0.05);持续时间:健侧、患侧分别为(100.58±36.56)s、(118.65±43.71)s,持续时间均大于60s,二者差异无统计学意义(P>0.05);强度:健侧、患侧分别为(45.58±28.71)°/s、(20.42±16.64)°/s,健侧眼震强度明显大于患侧,差异有统计学意义(P<0.05)。其中右侧HSC-Cup患者23例,左侧HSC-Cup患者13例。所有患者采取上述治疗方法1周后复诊,28例(77.77%)痊愈,36例(100.00%)有效。随访期间4例复发。结论:根据眼震方向和持续时间可做出HSC-Cup的诊断,根据眼震强度可判断受累侧别。避免健侧卧位及口服敏使朗对治疗HSC-Cup简单有效。

Objective： By analysing the video-nystagmography findings of positional tests, to evaluate the therapeutic effect of the patients with horizontal semicircular canal cupulolithiasis （HSC Cup）. Method： A retrospective study of 36 patients with HSC-Cup. The induced nystagmus in roll tests was recorded by videonystagmography, whose direction, latency, intensity and time characteristics were analysed. All of the 36 patients were treated with lying position avoiding normal side and oral-taken betahistine mesilate tablets. A week later return visits and curative effects evaluation were made. Result： Horizontal apogeotropic nystagmus was induced by turning left or right in HSC-Cup roll tests. The time of latency and duration turning to normal and lesion side were （0.93 ± 0.65 ） s and （ 1.01 ± 0.78） s, （ 100.58 ±36.56 ） s and （118.65 ± 43.71） s, which showed no statistically significant difference （P〉0.05）. The duration of nystagmus was more than 60 seconds. The intensity of nystagmus turning to normal and lesion side were（ 45.58± 28, 71）°/s and （20. 42±16.64）°/s. The intensity turning to normal side was greater than lesion side obviously. The difference was statistically significant （P〈0.05）. Twenty-three patients withright HSC-Cup, and 13 patients with left HSC-Cup were taken incount. They were treated with above methods and return visit a week later. Twenty eight patients （77.77%） were cured,36 patients （100.00%） were improved. There were 4 patients recurrence during the follow-up. Coneluslon：The direction and duration time of induced nystagmus are available to diagnose the HSC-Cup. The lesion side may determined according to the intensity of induced nystagmus. Lying position avoiding normal side and oral- taken betahistine mesilate tablets is an effective treatment methods for HSC-Cup.