老年性聋患者颈源性前庭诱发肌源性电位的变化及意义

Cervical vestibular evoked myogenic potential in patients with presbycusis

目的分析老年人听力损失与前庭终器之间的关系,同时评估听力下降和耳石器功能减退的共同危险因素。方法选择120例没有前庭症状的老年人,分为观察组(伴有听力下降)和对照组(正常听力),采用纯音听阈测听和颈源性前庭诱发肌源性电位(cVEMP)来评估听力和球囊的功能,并比较两组cVEMP的结果。结果与对照组对比,观察组c VEMP的P1波和N1波潜伏期延长(t=4.67、4.59,P<0.05),振幅降低(t=6.72,P<0.05)。观察组的高频听力损失越大,其cVEMP振幅越小(r=-0.41,P<0.05),噪声暴露也与cVEMP振幅密切相关(β=-0.52,P<0.05)。结论在不伴有前庭症状的情况下,老年性耳聋患者可合并球囊功能的减退,其高频听阈与球囊功能密切相关,噪声是耳蜗与球囊功能的共同危险因素。

Objective To explore the association between hearing loss and dysfunction of the vestibularend-organ in older individuals. To evaluate the common risk factors for hearing loss and otolith dysfunction. Methods A total of 120 elderly patients without any vestibular symptoms were recruited in this study. They were divid-ed into two groups：a study group（patients with presbycusis）and a control group（patients without presbycusis）.Audiological status was measured with pure tone audiometry and the saccular function was tested with cervical ves-tibular evoked myogenic potential（cVEMP）. The results of cVEMP were calculated and compared between the twogroups. Results Comparing to the control group,mean P1 and N1 latencies were significantly prolonged（t =4.67,4.59,P〈0.05）and the amplitudes were signi cantly reduced（t=6.72,P〈0.05）in the study group. A sig-nificant correlation between hearing loss at high frequencies and reduced c VEMP amplitudes（r=-0.41,P〈0.05）were observed in the study group. Noise exposure was significantly associated with cVEMP amplitude（β=-0.52,P〈0.05）. Conclusions Presbycusis may be accompanied by the hypofunction of saccular function without anyvestibular symptoms,and the high frequency hearing threshold is closely related to the saccular function. Noise ex-posure appears to be related to both cochlear and saccular dysfunction.