突发性聋患者的前庭损伤

Vestibular Injury in Patients with Sudden Deafness

目的研究突发性聋患者前庭损伤的范围、特点及与预后的关系。方法回顾性分析我院2019.5—2020.11住院治疗的突发性聋患者资料共计43例,通过温度实验联合视频甩头试验(Video headimpulse test,vHIT)、颈性前庭诱发肌源性电位(cervical vestibular evoked myogenic potential,cVEMP)、眼性前庭诱发肌源性电位测试(oc‐ular vestibular evoked myogenic potential,oVEMP)等前庭功能检查分别评估突发性聋患者半规管、球囊、椭圆囊损伤情况。分组比较前庭功能异常与临床症状、预后的关系。结果本组病例发现温度实验异常14例,vHIT异常14例,cVEMP异常8例、oVEMP异常9例,因此突聋患者的前庭损害以半规管为主,其次为椭圆囊、球囊。统计比较发现伴有眩晕的患者更容易出现半规管功能障碍,并且半规管损伤与患者的预后呈负相关。VEMP异常与患者是否伴有眩晕、治疗预后无明显相关性。结论突发性聋患者除了耳蜗受损,部分患者前庭器官亦广泛受累,以半规管损伤为主。前庭损伤的评估对疾病的病因、治疗及预后均有积极意义。

Objective To report the extent and characteristics of vestibular injury in patients with sudden deafness and its prognosis.Methods Data from 43 patients with sudden deafness admitted to our hospital from May 2019 to November 2020 were retrospective analyzed,including caloric test with video head impulse test(vHIT),cervical vestibular evoked myogenic potentials(cVEMPs)and ocular vestibular evoked myogenic potentials(oVEMPs)to evaluate function of the semicircular canals,saccule and utricule.Correlations among abnormal vestibular function,clinical symptoms and prognosis were examined.Results In this group of cases,14 showed abnormal CT results,8 showed abnormal cVEMPs and 9 had abnormal oVEMPs,indicating involvement of semicircular canals as the main vestibular lesion in patients with sudden deafness,followed by the utricle and saccule.We found that patients with vertigo were more prone to semicircular canal dysfunction,and semicircular canal injury was negatively correlated with patients’prognosis.There was no significant correlation between VEMP abnormality and vertigo or prognosis.Conclusion In addition to cochlear damage,vestibular organs were also extensively involved in some patients with sudden deafness.The mainly vestibular lesion involves semicircular canal.Evaluation of vestibular injury has positive significance in understanding etiology,treatment and prognosis of sudden deafness.