Objectives: The aim of our study is to examine vestibular-evoked myogenic potentials(VEMPs) elicited by the galvanic vestibular stimulation in the sternocleidomastoid muscle(SCM) in healthy subjects for clinical appli...Objectives: The aim of our study is to examine vestibular-evoked myogenic potentials(VEMPs) elicited by the galvanic vestibular stimulation in the sternocleidomastoid muscle(SCM) in healthy subjects for clinical applications of auditory neuropathy or vestibular neuropathy in the future.Methods: We enrolled sixteen healthy subjects to record the average responses of SCM to galvanic vestibular stimulation(GVS) [current 3 mA;duration 1 ms] by electromyography(EMG). SPSS 18.0 software was used to analyze the obtained data for mean and standard deviation.Results: In all healthy subjects mastoid-forehead galvanic vestibular stimulation produced a positive-negative biphasic EMG responses on SCM ipsilateral to the cathodal electrode. The latency of p13 was 11.7 ± 3.0 ms. The latency of n23 was 17.8 ± 3.4 ms. The amplitude of p13-n23 was147.0 ± 69.0 μV. The interaural asymmetry ratio(AR) of p13, n23 latency and the amplitude was respectively 0.12 ± 0.09, 0.08 ± 0.08 and0.16 ± 0.10.Discussions: Galvanic vestibular stimulation could elicit biphasic EMG responses from SCM via the vestibular nerve but not from the otolith organs. Galvanic stimulation together with air conducted sound(ACS) or bone conducted vibration(BCV) can elicit VEMPs and may enable the differentiation of retrolabyrinthine lesions from labyrinthine lesions in vestibular system.展开更多
Objective:To report vestibular evoked myogenic potentials from different recording sites(neck extensor or masseter muscles) in miniature pigs and rats.Methods:Potentials were recorded using 1000 Hz tone bursts from th...Objective:To report vestibular evoked myogenic potentials from different recording sites(neck extensor or masseter muscles) in miniature pigs and rats.Methods:Potentials were recorded using 1000 Hz tone bursts from the neck extensor muscle or masseter muscle in normal adult Bama miniature pigs and rats anesthetized with 3%pentobarbital sodium and Sumianxin Ⅱ.Results:At 80 dB SPL,the first positive wave(P wave) of VEMPs was recognizable in 58%of rats with a latency of 6.45±0.23 ms and an amplitude of 1.45±0.49 μV when recorded from the neck extensor muscle,and in 50%of rats with a latency of 6.38±0.34 ms and an amplitude of 1.57±0.35 μV when recorded from the masseter muscle.In miniature pigs,at the same stimulus intensity,P wave was recognizable in 58%of the animals with a latency of 7.65±0.64 ms and an amplitude of 1.66±0.34 μV when recorded from the neck extensor muscle,and in 50%of the animals with a latency of 7.65±0.64 ms and an amplitude of 0.31±0.28 μV when recorded from the masseter muscle.Conclusion:VEMP can be induced from both neck extensor and masseter muscles in the miniature pig and rat.For a given species,the site of recording affects P wave induction rate and amplitude but not latency.Consistency and repeatability analysis suggests that the masseter muscle is a better recording site in miniature pigs while the cervical extensor is a better recording site in rats.For a given recording site,both latency and amplitude of the P wave are slightly greater in miniature pigs than in rats.展开更多
Objective: To investigate the effects of conductive hearing loss(CHL) on vestibular evoked myogenic potentials(VEMPs) using a simulated CHL model, and to provide the basis for future studies.Methods: Twenty-one health...Objective: To investigate the effects of conductive hearing loss(CHL) on vestibular evoked myogenic potentials(VEMPs) using a simulated CHL model, and to provide the basis for future studies.Methods: Twenty-one healthy subjects were recruited in this study. We measured ocular VEMPs(o VEMPs) and cervical VEMPs(c VEMPs) in these subjects by air-conduction sound(ACS) stimulation. CHL was simulated later by blocking the right external auditory canal with a soundproof earplug to evaluate its impacts on VEMPs. Subjects' responses before simulated CHL served as the control, and were compared to their responses following simulated CHL.Results: o VEMPs following simulated CHL showed decreased response rate, elevated thresholds, attenuated amplitudes and prolonged N1 latencies compared with those before simulated CHL, and the differences were statistically significant. Similarly, c VEMPs following simulated CHL also showed decreased response rate, elevated thresholds and attenuated amplitudes, with prolonged P1 latencies compared with those before simulated CHL, although only differences in response rate, threshold and amplitude were significant.Conclusions: Conductive hearing loss affects the response rate and other response parameters in o VEMPs and c VEMPs.展开更多
Objective Auditory neuropathy(AN)is a unique pattern of hearing loss with preservation of hair cell function.The condition is characterized by the presence of otoacoustic emissions(OAE)or cochlear microphonic(CM)respo...Objective Auditory neuropathy(AN)is a unique pattern of hearing loss with preservation of hair cell function.The condition is characterized by the presence of otoacoustic emissions(OAE)or cochlear microphonic(CM)responses with severe abnormalities of the auditory brainstem response(ABR).The vestibular branches of the VIII cranial nerve and the structures innervated by it can also be affected.However,the precise lesion sites in the vestibular system are not well characterized in patients with AN.Methods The air-conducted sound(ACS)vestibular-evoked myogenic potentials(VEMPs)and galvanic vestibular stimuli(GVS)-VEMPs were examined in 14 patients with AN.Results On examination of VEMPs(n=14,28 ears),the absent rates of ACS-cervical VEMP(cVEMP),ACS-ocular VEMP(oVEMP),GVS-cVEMP,GVS-oVEMP and caloric test were 92.9%(26/28),85.7%(24/28),67.9%(19/28),53.6%(15/28),and 61.5%(8/13),respectively.Impaired functions of the saccule,inferior vestibular nerve,utricle,superior vestibular nerve,and horizontal semicircular canal were found in 25.0%(7/28),67.9%(19/28),32.1%(9/28),53.6%(15/28)and 61.5%(8/13)patients,respectively.On comparing the elicited VEMPs parameters of AN patients with those of normal controls,both ACS-VEMPs and GVS-VEMPs showed abnormal results in AN patients(such as,lower presence rates,elevated thresholds,prolonged latencies,and decreased amplitudes).Conclusion The study suggested that patients with AN often have concomitant vestibular disorders.Retro-labyrinthine lesions were more frequently observed in this study.GVS-VEMPs combined with ACS-VEMPs may help identify the lesion sites and facilitate detection of areas of vestibular dysfunction in these patients.展开更多
BACKGROUND Healthy vestibular system adjusts balance during static and dynamic conditions.This is important for normal development(standing up and walking).Vestipulopathies(central and peripheral)are common complicati...BACKGROUND Healthy vestibular system adjusts balance during static and dynamic conditions.This is important for normal development(standing up and walking).Vestipulopathies(central and peripheral)are common complications of diabetes in adult population.Related studies are scare in children with type 1 diabetes(T1D).AIM To assess saccular function of otolith organ in children with T1D and predictors for its dysfunction.METHODS Cervical vestibular evoked myogenic potential(cVEMP)was used for objective evaluation.RESULTS The study included 40 patients(boys=15;girls=25).Patients had mean age of 13.63±1.50 years,duration of diabetes of 5.62±2.80 years,frequent attacks of diabetic ketoacidosis(55%)and hypoglycemia(30%),hyperlipidemia(20%),hypertension(12.5%)and peripheral neuropathy(40%).Dizziness was found in 10%.Compared to healthy children(n=25),patients had prolonged cVEMP P1 and N1 latencies and reduced P1-N1 amplitude.Bilateral cVEMP abnormalities were found in 60%(vs 25%for unilateral abnormalities).Higher frequencies and severe vestibulopathies were found with chronic diabetes of>5 years,hemoglobin A1c values>7%,frequent diabetic ketoacidosis and hypoglycemic attacks and presence of dizziness.Regression analyses showed that predictors for prolonged P1 latencies and reduced P1-N1 amplitudes were only chronic diabetes(>5 years){odds ratio(OR)=2.80[95%confidence interval(CI):1.80–5.33],P=0.01;OR=3.42(95%CI:2.82–6.81)}and its severity(hemoglobin A1c>7%)[OR=3.05(95%CI:2.55–6.82),P=0.01;OR=4.20(95%CI:3.55–8.50),P=0.001].CONCLUSION Dysfunction or injury of the saccular macula and its pathways is prevalent in children with T1D.Optimum glycemic control is important to prevent diabetes related vestipulopathies.展开更多
Although the exact mechanism and most involved region of the vestibular system have not yet been fully clarified, vestibular dysfunction has been demonstrated in patients with diabetes mellitus (DM). Vestibular evoked...Although the exact mechanism and most involved region of the vestibular system have not yet been fully clarified, vestibular dysfunction has been demonstrated in patients with diabetes mellitus (DM). Vestibular evoked myogenic potential (VEMP) is a short latency electromyographic response to sound or vibration stimuli that may reflect otolith organ or related reflex functions. Since its first description in 1992, VEMP has become a significant part of the vestibular test battery as an objective measurement tool. In diabetic patients, VEMP responses have been studied in order to determine any otolith organ or related reflex dysfunctions. Here, we review the literature with regard to VEMP findings representing any peripheral vestibular end-organ dysfunction in patients with DM. Distinctive vestibular end-organ impairments seem to be demonstrated in patients with DM either with or without DNP via objective vestibular testing tools including VEMP recordings according to relevant studies. However, further studies with larger sample sizes are required to reveal the more definitive findings of VEMP recordings regarding the vestibular pathologies in patients with DM.展开更多
BACKGROUND Numerous studies have found that patients experiencing sudden sensorineural hearing loss(SSHL),with or without accompanying vertigo,often show impaired vestibular function.However,there is a dearth of studi...BACKGROUND Numerous studies have found that patients experiencing sudden sensorineural hearing loss(SSHL),with or without accompanying vertigo,often show impaired vestibular function.However,there is a dearth of studies analyzing vestibularevoked myogenic potentials(VEMPs)in SSHL patients across various age groups.AIM To investigate vestibular condition in SSHL patients across various age demographics.METHODS Clinical data of 84 SSHL patients were investigated retrospectively.Audiometry,cervical vestibular evoked myogenic potentials(c-VEMPs),and ocular vestibular evoked myogenic potentials(o-VEMPs)were conducted on these patients.Parameters assessed included the latencies of P1 and N1 waves,as well as the amplitudes of P1–N1 waves.Moreover,the study evaluated the influence of factors such as sex,affected side,configuration of hearing loss,and presence of accompanying vertigo.RESULTS Among the 84 SSHL patients,no significant differences were observed among the three groups in terms of gender,affected side,and the presence or absence of vertigo.Group II(aged 41–60 years)had the highest number of SSHL cases.The rates of absent o-VEMPs in the affected ears were 20.83%,31.58%,and 22.72%for the three age groups,respectively,with no statistically significant difference among them.The rates of absent c-VEMPs in the affected ears were 8.3%,34.21%,and 18.18%for the three age groups,respectively,with significant differences.In the unaffected ears,there were differences observed in the extraction rates of o-VEMPs in the unaffected ears among the age groups.In the three age groups,no significant differences were noted in the three age groups in the latencies of P1 and N1 waves or in the amplitude of N1–P1 waves for c-VEMPs and o-VEMPs,either on the affected side or on the unaffected side,across the three age groups.CONCLUSION The extraction rate of VEMPs is more valuable than parameters.Regardless of the presence of vertigo,vestibular organs are involved in SSHL.Notably,SSHL patients aged 41–60 appear more susceptible to damage to the inferior vestibular nerve and saccule.展开更多
目的:了解刺激声强度差异对正常人气导短纯音诱发的眼肌前庭诱发肌源性电位(ocular vestibular-evoked myogenic potential, oVEMP)和颈肌前庭肌源性诱发电位(cervical vestibular-evoked myogenic potential, cVEMP)的影响。方法...目的:了解刺激声强度差异对正常人气导短纯音诱发的眼肌前庭诱发肌源性电位(ocular vestibular-evoked myogenic potential, oVEMP)和颈肌前庭肌源性诱发电位(cervical vestibular-evoked myogenic potential, cVEMP)的影响。方法选择国人正常人35例作为研究对象,男16例,女19例,年龄4~40岁(20.80±8.89),以500Hz tone brust为刺激音,按照100、95、90、85、80、75 dB nHL依次进行气导oVEMP和cVEMP检测,计算VEMP在不同刺激声强度的引出率、nI潜伏期、pI潜伏期、nI-pI波间期、振幅值和AR值,进行波形参数计算和声强度组间对比。结果全组正常人oVEMP和cVEMP的阈值分别为86.5±4.37 dB nHL、83.57±4.52 dB nHL。随着刺激声强度的减弱,无论oVEMP还是cVEMP,均表现出引出率下降、振幅减低等特点。在刺激声强度为100 dB nHL和95 dB nHL时,oVEMP和cVEMP的引出率均为100%,两者之间图形参数差异并不显著。结论随着刺激声强度的减弱,oVEMP和cVEMP出现引出率下降、振幅减低的趋势。对于40岁以下的国人人群,建议采用95 dB nHL作为VEMPs测试的最大起始刺激强度。展开更多
This study investigated the relationship among the severity of hearing impairment,vestibular function and balance function in patients with idiopathic sudden sensorineural hearing loss(ISSNHL).A total of 35 ISSNHL p...This study investigated the relationship among the severity of hearing impairment,vestibular function and balance function in patients with idiopathic sudden sensorineural hearing loss(ISSNHL).A total of 35 ISSNHL patients(including 21 patients with vertigo) were enrolled.All of the patients underwent audiometry,sensory organization test(SOT),caloric test,cervical vestibular-evoked myogenic potential(cV EMP) test and ocular vestibular-evoked myogenic potential(o VEMP) test.Significant relationship was found between vertigo and hearing loss grade(P=0.009),and between SOT VEST grade and hearing loss grade(P=0.001).The abnormal rate of o VEMP test was the highest,followed by the abnormal rates of caloric and c VEMP tests,not only in patients with vertigo but also in those without vertigo.The vestibular end organs were more susceptible to damage in patients with vertigo(compared with patients without vertigo).Significant relationship was found between presence of vertigo and SOT VEST grade(P=0.010).We demonstrated that vestibular end organs may be impaired not only in patients with vertigo but also in patients without vertigo.The cochlear and vestibular impairment could be more serious in patients with vertigo than in those without vertigo.Vertigo does not necessarily bear a causal relationship with the impairment of the vestibular end organs.SOT VEST grade could be used to reflect the presence of vertigo state in the ISSNHL patients.Apart from audiometry,the function of peripheral vestibular end organs and balance function should be evaluated to comprehensively understand ISSNHL.Better assessment of the condition will help us in clinical diagnosis,treatment and prognosis evaluation of ISSNHL.展开更多
基金supported by Japan China Sasakawa Medical Fellowship 2016(YL)
文摘Objectives: The aim of our study is to examine vestibular-evoked myogenic potentials(VEMPs) elicited by the galvanic vestibular stimulation in the sternocleidomastoid muscle(SCM) in healthy subjects for clinical applications of auditory neuropathy or vestibular neuropathy in the future.Methods: We enrolled sixteen healthy subjects to record the average responses of SCM to galvanic vestibular stimulation(GVS) [current 3 mA;duration 1 ms] by electromyography(EMG). SPSS 18.0 software was used to analyze the obtained data for mean and standard deviation.Results: In all healthy subjects mastoid-forehead galvanic vestibular stimulation produced a positive-negative biphasic EMG responses on SCM ipsilateral to the cathodal electrode. The latency of p13 was 11.7 ± 3.0 ms. The latency of n23 was 17.8 ± 3.4 ms. The amplitude of p13-n23 was147.0 ± 69.0 μV. The interaural asymmetry ratio(AR) of p13, n23 latency and the amplitude was respectively 0.12 ± 0.09, 0.08 ± 0.08 and0.16 ± 0.10.Discussions: Galvanic vestibular stimulation could elicit biphasic EMG responses from SCM via the vestibular nerve but not from the otolith organs. Galvanic stimulation together with air conducted sound(ACS) or bone conducted vibration(BCV) can elicit VEMPs and may enable the differentiation of retrolabyrinthine lesions from labyrinthine lesions in vestibular system.
基金supported by grants from the National Basic Research Program of China (973 Program)(#2012CB967900)National Natural Science Foundation of China (31300624,81470684)+3 种基金Postdoctoral Science Foundation of China (2015M571818)Six Major Categories of Talent (2014-WSN043,2011-WS-074)Innovation and Entrepreneurship Training Program for College Students in Jiangsu Province(201510313003Z,201510313003,KYLX14-1455)Clinic Medical Special Foundation of Jiangsu Province (b12014032)
文摘Objective:To report vestibular evoked myogenic potentials from different recording sites(neck extensor or masseter muscles) in miniature pigs and rats.Methods:Potentials were recorded using 1000 Hz tone bursts from the neck extensor muscle or masseter muscle in normal adult Bama miniature pigs and rats anesthetized with 3%pentobarbital sodium and Sumianxin Ⅱ.Results:At 80 dB SPL,the first positive wave(P wave) of VEMPs was recognizable in 58%of rats with a latency of 6.45±0.23 ms and an amplitude of 1.45±0.49 μV when recorded from the neck extensor muscle,and in 50%of rats with a latency of 6.38±0.34 ms and an amplitude of 1.57±0.35 μV when recorded from the masseter muscle.In miniature pigs,at the same stimulus intensity,P wave was recognizable in 58%of the animals with a latency of 7.65±0.64 ms and an amplitude of 1.66±0.34 μV when recorded from the neck extensor muscle,and in 50%of the animals with a latency of 7.65±0.64 ms and an amplitude of 0.31±0.28 μV when recorded from the masseter muscle.Conclusion:VEMP can be induced from both neck extensor and masseter muscles in the miniature pig and rat.For a given species,the site of recording affects P wave induction rate and amplitude but not latency.Consistency and repeatability analysis suggests that the masseter muscle is a better recording site in miniature pigs while the cervical extensor is a better recording site in rats.For a given recording site,both latency and amplitude of the P wave are slightly greater in miniature pigs than in rats.
基金supported by grants from the National Natural Science Foundation of China, China (No. 81670945, 81541040)Fundamental Research Funds for the Central Universities, China (No. 2012jdhz13)+1 种基金Shaanxi Major International Cooperative Project, China (No. 2013KW-28)Key Science and Technology Program of Xi'an, China (No. SF1315(1))
文摘Objective: To investigate the effects of conductive hearing loss(CHL) on vestibular evoked myogenic potentials(VEMPs) using a simulated CHL model, and to provide the basis for future studies.Methods: Twenty-one healthy subjects were recruited in this study. We measured ocular VEMPs(o VEMPs) and cervical VEMPs(c VEMPs) in these subjects by air-conduction sound(ACS) stimulation. CHL was simulated later by blocking the right external auditory canal with a soundproof earplug to evaluate its impacts on VEMPs. Subjects' responses before simulated CHL served as the control, and were compared to their responses following simulated CHL.Results: o VEMPs following simulated CHL showed decreased response rate, elevated thresholds, attenuated amplitudes and prolonged N1 latencies compared with those before simulated CHL, and the differences were statistically significant. Similarly, c VEMPs following simulated CHL also showed decreased response rate, elevated thresholds and attenuated amplitudes, with prolonged P1 latencies compared with those before simulated CHL, although only differences in response rate, threshold and amplitude were significant.Conclusions: Conductive hearing loss affects the response rate and other response parameters in o VEMPs and c VEMPs.
基金supported by grants from the National Natural Science Foundation of China(No.81670945,No.81970891,No.81600809,No.81700915)the Shaanxi Major International Cooperative Project of China(No.2020KWZ-019)the Key R&D Projects in Shaanxi Province,China(No.2018SF-189).
文摘Objective Auditory neuropathy(AN)is a unique pattern of hearing loss with preservation of hair cell function.The condition is characterized by the presence of otoacoustic emissions(OAE)or cochlear microphonic(CM)responses with severe abnormalities of the auditory brainstem response(ABR).The vestibular branches of the VIII cranial nerve and the structures innervated by it can also be affected.However,the precise lesion sites in the vestibular system are not well characterized in patients with AN.Methods The air-conducted sound(ACS)vestibular-evoked myogenic potentials(VEMPs)and galvanic vestibular stimuli(GVS)-VEMPs were examined in 14 patients with AN.Results On examination of VEMPs(n=14,28 ears),the absent rates of ACS-cervical VEMP(cVEMP),ACS-ocular VEMP(oVEMP),GVS-cVEMP,GVS-oVEMP and caloric test were 92.9%(26/28),85.7%(24/28),67.9%(19/28),53.6%(15/28),and 61.5%(8/13),respectively.Impaired functions of the saccule,inferior vestibular nerve,utricle,superior vestibular nerve,and horizontal semicircular canal were found in 25.0%(7/28),67.9%(19/28),32.1%(9/28),53.6%(15/28)and 61.5%(8/13)patients,respectively.On comparing the elicited VEMPs parameters of AN patients with those of normal controls,both ACS-VEMPs and GVS-VEMPs showed abnormal results in AN patients(such as,lower presence rates,elevated thresholds,prolonged latencies,and decreased amplitudes).Conclusion The study suggested that patients with AN often have concomitant vestibular disorders.Retro-labyrinthine lesions were more frequently observed in this study.GVS-VEMPs combined with ACS-VEMPs may help identify the lesion sites and facilitate detection of areas of vestibular dysfunction in these patients.
文摘BACKGROUND Healthy vestibular system adjusts balance during static and dynamic conditions.This is important for normal development(standing up and walking).Vestipulopathies(central and peripheral)are common complications of diabetes in adult population.Related studies are scare in children with type 1 diabetes(T1D).AIM To assess saccular function of otolith organ in children with T1D and predictors for its dysfunction.METHODS Cervical vestibular evoked myogenic potential(cVEMP)was used for objective evaluation.RESULTS The study included 40 patients(boys=15;girls=25).Patients had mean age of 13.63±1.50 years,duration of diabetes of 5.62±2.80 years,frequent attacks of diabetic ketoacidosis(55%)and hypoglycemia(30%),hyperlipidemia(20%),hypertension(12.5%)and peripheral neuropathy(40%).Dizziness was found in 10%.Compared to healthy children(n=25),patients had prolonged cVEMP P1 and N1 latencies and reduced P1-N1 amplitude.Bilateral cVEMP abnormalities were found in 60%(vs 25%for unilateral abnormalities).Higher frequencies and severe vestibulopathies were found with chronic diabetes of>5 years,hemoglobin A1c values>7%,frequent diabetic ketoacidosis and hypoglycemic attacks and presence of dizziness.Regression analyses showed that predictors for prolonged P1 latencies and reduced P1-N1 amplitudes were only chronic diabetes(>5 years){odds ratio(OR)=2.80[95%confidence interval(CI):1.80–5.33],P=0.01;OR=3.42(95%CI:2.82–6.81)}and its severity(hemoglobin A1c>7%)[OR=3.05(95%CI:2.55–6.82),P=0.01;OR=4.20(95%CI:3.55–8.50),P=0.001].CONCLUSION Dysfunction or injury of the saccular macula and its pathways is prevalent in children with T1D.Optimum glycemic control is important to prevent diabetes related vestipulopathies.
文摘Although the exact mechanism and most involved region of the vestibular system have not yet been fully clarified, vestibular dysfunction has been demonstrated in patients with diabetes mellitus (DM). Vestibular evoked myogenic potential (VEMP) is a short latency electromyographic response to sound or vibration stimuli that may reflect otolith organ or related reflex functions. Since its first description in 1992, VEMP has become a significant part of the vestibular test battery as an objective measurement tool. In diabetic patients, VEMP responses have been studied in order to determine any otolith organ or related reflex dysfunctions. Here, we review the literature with regard to VEMP findings representing any peripheral vestibular end-organ dysfunction in patients with DM. Distinctive vestibular end-organ impairments seem to be demonstrated in patients with DM either with or without DNP via objective vestibular testing tools including VEMP recordings according to relevant studies. However, further studies with larger sample sizes are required to reveal the more definitive findings of VEMP recordings regarding the vestibular pathologies in patients with DM.
基金the Innovative Program of Hebei Provincial Eye Hospital,No.2023ZZ107.
文摘BACKGROUND Numerous studies have found that patients experiencing sudden sensorineural hearing loss(SSHL),with or without accompanying vertigo,often show impaired vestibular function.However,there is a dearth of studies analyzing vestibularevoked myogenic potentials(VEMPs)in SSHL patients across various age groups.AIM To investigate vestibular condition in SSHL patients across various age demographics.METHODS Clinical data of 84 SSHL patients were investigated retrospectively.Audiometry,cervical vestibular evoked myogenic potentials(c-VEMPs),and ocular vestibular evoked myogenic potentials(o-VEMPs)were conducted on these patients.Parameters assessed included the latencies of P1 and N1 waves,as well as the amplitudes of P1–N1 waves.Moreover,the study evaluated the influence of factors such as sex,affected side,configuration of hearing loss,and presence of accompanying vertigo.RESULTS Among the 84 SSHL patients,no significant differences were observed among the three groups in terms of gender,affected side,and the presence or absence of vertigo.Group II(aged 41–60 years)had the highest number of SSHL cases.The rates of absent o-VEMPs in the affected ears were 20.83%,31.58%,and 22.72%for the three age groups,respectively,with no statistically significant difference among them.The rates of absent c-VEMPs in the affected ears were 8.3%,34.21%,and 18.18%for the three age groups,respectively,with significant differences.In the unaffected ears,there were differences observed in the extraction rates of o-VEMPs in the unaffected ears among the age groups.In the three age groups,no significant differences were noted in the three age groups in the latencies of P1 and N1 waves or in the amplitude of N1–P1 waves for c-VEMPs and o-VEMPs,either on the affected side or on the unaffected side,across the three age groups.CONCLUSION The extraction rate of VEMPs is more valuable than parameters.Regardless of the presence of vertigo,vestibular organs are involved in SSHL.Notably,SSHL patients aged 41–60 appear more susceptible to damage to the inferior vestibular nerve and saccule.
文摘目的:了解刺激声强度差异对正常人气导短纯音诱发的眼肌前庭诱发肌源性电位(ocular vestibular-evoked myogenic potential, oVEMP)和颈肌前庭肌源性诱发电位(cervical vestibular-evoked myogenic potential, cVEMP)的影响。方法选择国人正常人35例作为研究对象,男16例,女19例,年龄4~40岁(20.80±8.89),以500Hz tone brust为刺激音,按照100、95、90、85、80、75 dB nHL依次进行气导oVEMP和cVEMP检测,计算VEMP在不同刺激声强度的引出率、nI潜伏期、pI潜伏期、nI-pI波间期、振幅值和AR值,进行波形参数计算和声强度组间对比。结果全组正常人oVEMP和cVEMP的阈值分别为86.5±4.37 dB nHL、83.57±4.52 dB nHL。随着刺激声强度的减弱,无论oVEMP还是cVEMP,均表现出引出率下降、振幅减低等特点。在刺激声强度为100 dB nHL和95 dB nHL时,oVEMP和cVEMP的引出率均为100%,两者之间图形参数差异并不显著。结论随着刺激声强度的减弱,oVEMP和cVEMP出现引出率下降、振幅减低的趋势。对于40岁以下的国人人群,建议采用95 dB nHL作为VEMPs测试的最大起始刺激强度。
基金supported by grants from the National Twelfth Five-Year Science and Technology Support Program of China(No.2012BAI12B02)the National Eleventh Five-Year Science and Technology Support Program of China(No.2007BAI18B13)
文摘This study investigated the relationship among the severity of hearing impairment,vestibular function and balance function in patients with idiopathic sudden sensorineural hearing loss(ISSNHL).A total of 35 ISSNHL patients(including 21 patients with vertigo) were enrolled.All of the patients underwent audiometry,sensory organization test(SOT),caloric test,cervical vestibular-evoked myogenic potential(cV EMP) test and ocular vestibular-evoked myogenic potential(o VEMP) test.Significant relationship was found between vertigo and hearing loss grade(P=0.009),and between SOT VEST grade and hearing loss grade(P=0.001).The abnormal rate of o VEMP test was the highest,followed by the abnormal rates of caloric and c VEMP tests,not only in patients with vertigo but also in those without vertigo.The vestibular end organs were more susceptible to damage in patients with vertigo(compared with patients without vertigo).Significant relationship was found between presence of vertigo and SOT VEST grade(P=0.010).We demonstrated that vestibular end organs may be impaired not only in patients with vertigo but also in patients without vertigo.The cochlear and vestibular impairment could be more serious in patients with vertigo than in those without vertigo.Vertigo does not necessarily bear a causal relationship with the impairment of the vestibular end organs.SOT VEST grade could be used to reflect the presence of vertigo state in the ISSNHL patients.Apart from audiometry,the function of peripheral vestibular end organs and balance function should be evaluated to comprehensively understand ISSNHL.Better assessment of the condition will help us in clinical diagnosis,treatment and prognosis evaluation of ISSNHL.