前庭诱发肌源电位在听神经瘤诊断中的应用

Vestibular-Evoked Myogenic Potentials in Diagnosis of Unilateral Acoustic Neuroma

目的探讨前庭诱发肌源电位在听神经瘤临床诊断中的价值。方法选取听神经瘤患者(AN)26名为研究对象,听力正常健康人30名作为对照组,两组对象均接受眼性前庭诱发肌源性电位(oVEMP)测试和颈肌前庭诱发肌源性电位(cVEMP),分析对比两组之间oVEMPs和cVEMP的引出率及各参数指标。结果与对照组相比,听神经瘤组cVEMP和oVEMP的引出率较低,cVEMP的振幅减小,cVEMP和oVEMP的幅度比和不对称比(AR)增大,oVEMP的n10潜伏期较长,cVEMP和oVEMP结果与瘤体大小、听力损失程度无明显相关性。结论cVEMP和oVEMP检测对听神经瘤的诊断有一定参考价值;引出率较低、VEMP振幅减小可能有助于听神经瘤筛查和诊断;cVEMP和oVEMP易于操作且稳定性高,联合检查可提高听神经瘤的检出率。

Objective To investigate the value of vestibular evoked myogenic potentials in the diagnosis of acoustic neuroma.Methods Twenty six patients with acoustic neuroma were included in the study,and 30 healthy normal hearing subjects served as the control group.Both groups underwent audiometry,oVEMP and cVEMP tests.Results Compared with the control group,the rates of cVEMP and oVEMP induction were lower in patients with acoustic neuroma,with reduced cVEMP amplitudes,higher cVEMP and oVEMPamplitude ratio and asymmetry ratio(AR)and longer oVEMP n10 latency,although cVEMP and oVEMP results were not significantly different among acoustic neuroma patients regarding tumor size or level of hearing loss.Conclusion cVEMP and oVEMP may have certain values in the diagnosis of acoustic neuroma.The lower induction rate and decreased amplitude of VEMPs may help diagnosing acoustic neuroma.cVEMP and oVEMP tests are easy and highly consistent and can be combined with other tests to improve detection of acoustic neuroma.