双侧大前庭水管综合征患儿的前庭诱发肌源性电位特征

Vestibular Evoked Myogenic Potentials in Children with Bilateral Vestibular Aqueduct Syndrome

目的探讨儿童双侧大前庭水管综合征(large vestibular aqueduct syndrome, LVAS)患者的前庭诱发肌源性电位(vestibular evoked myogenic potential, VEMP)的波形特征。方法对双侧大前庭水管综合征患儿21例(42耳)(LVAS组)、年龄和性别相匹配的非LVAS聋哑症患儿14例(28耳)(非LVAS聋哑症组)及健康儿童12例(24耳)(健康对照组)进行眼肌前庭诱发肌源性电位(ocular VEMP, oVEMP)和颈肌前庭诱发肌源性电位(cervical VEMP, cVEMP)检测,比较三组各波的引出率及波形特点。结果与非LVAS聋哑症组比较,LVAS组oVEMP的引出率较高(P<0.001),阈值较低(P<0.001)、振幅较高(P=0.003),n1、p1波潜伏期、n1-p1波间期组间差异无统计学意义(P>0.05)。与非LVAS聋哑症组患儿相比较,LVAS组患儿cVEMP的引出率较高(P=0.017),阈值较低(P=0.001),p1波潜伏期较短(P=0.009);其余指标两组间差异无统计学意义(P>0.05)。与健康对照组比较,LVAS组患儿的oVEMP振幅较高(P=0.027),其余指标两组间差异无统计学意义(P>0.05);cVEMP的各项指标差异均无统计学意义(P>0.05)。结论 LVAS患儿oVEMP及cVEMP引出率较非LVAS聋哑组高,与健康对照组无统计学差异;VEMP可用于评估LVAS患儿的前庭耳石器功能状态,但是并不恒定地都表现为阈值低、振幅高的特点。

Objective To study the characteristics of vestibular evoked myogenic potential (VEMP) in children with bilateral large vestibular aqueduct syndrome (LVAS). Methods A retrospective analysis of 21 children diagnosed with bilateral large vestibular aqueduct syndrome (LVAS group) was carried out. Fourteen children with non-LVAS deafness were selected as non-LVAS deaf-mutism group, and 12 healthy children with no statistical difference between age and gender were selected as normal control group. The oVEMP and cVEMP parameters were compared. Results There were significant differences in the oVEMP response rates( P < 0.001 ), thresholds( P < 0.001 ), and amplitudes( P = 0.003 ) between the LVAS group and the deaf-mutism group. The LVAS group had a higher prevalence of oVEMP, a low threshold and high amplitude performance. There was no significant difference between n1 wave latency, p1 wave latency, and n1-p1 interval ( P > 0.05 ). There was a statistically significant difference in the cVEMP response rates ( P = 0.017 ), thresholds ( P = 0.001 ), and p1 wave latencies ( P = 0.009 ) between the LVAS group and the deaf-mutism group. The LVAS group had a higher prevalence of cVEMP, a low threshold and shorter latency of p1 wave. However, there were no significant differences between the two groups in the remaining parameters( P > 0.05 ).There was a statistically significant difference in the amplitudes of oVEMP between the LVAS group and the healthy control group ( P = 0.027 ). The oVEMP in the LVAS group had a high amplitude. There was no significant difference between the two groups in the remaining parameters( P > 0.05 ). There was no significant difference in cVEMP parameters between LVAS group and healthy control group ( P > 0.05 ). Conclusion The response rates of oVEMP and cVEMP were higher in LVAS group than in non-LVAS deaf-mutism group, but there was no statistical difference between LVAS group and control group. VEMP can be used to assess the functional status of vestibular otoliths in children with LVAS. However, it does not always exhibit the characteristics of low threshold and high amplitude.