Effect of health education based on information-motivationbehavioral skills model on patients with unilateral vestibular dysfunction

BACKGROUND Vestibular dysfunction(VH)is a common concomitant symptom of late peri-pheral vestibular lesions,which can be trauma,poisoning,infection,heredity,and neurodegeneration,but about 50%of the causes are unknown.The study uses the information-motivation-behavioral skills(IMB)model for health education,effectively improve the quality of life,increase their self-confidence,reduce anxiety and depression,and effectively improve the psychological state of patients.AIM To explore the effect of health education based on the IMB model on the degree of vertigo,disability,anxiety and depression in patients with unilateral vestibular hypofunction.METHODS The clinical data of 80 patients with unilateral vestibular hypofunction from January 2019 to December 2021 were selected as the retrospective research objects,and they were divided into the control group and the observation group with 40 cases in each group according to different nursing methods.Among them,the control group was given routine nursing health education and guidance,and the observation group was given health education and guidance based on the IMB model.The changes in self-efficacy,anxiety and depression,and quality of life of patients with unilateral VH were compared between the two groups.RESULTS There was no significant difference in General Self-Efficacy Scale(GSES)scale scores between the two groups of patients before nursing(P>0.05),which was comparable;after nursing,the GSES scale scores of the two groups were higher than those before nursing.The nursing group was higher than the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the scores of Hospital Anxiety and Depression Scale(HADS)and anxiety and depression subscales between the two groups before nursing(P>0.05).After nursing,the HADS score,anxiety,and depression subscale scores of the two groups of patients were lower than those before nursing,and the nursing group was lower than the control group,and the difference was statistically significant(P<0.05).After nursing,the Dizziness Handicap Inventory(DHI)scale and DHI-P,DHI-E and DHI-F scores in the two groups were decreased,and the scores in the nursing group were lower than those in the control group,and the difference was statistically significant(P<0.05).CONCLUSION Health education based on the IMB model can effectively improve patients'quality of life,increase self-efficacy of patients with unilateral vestibular hypofunction,enhance patients'confidence,enable patients to resume normal work and life as soon as possible,reduce patients'anxiety and depression,and effectively improve patients'psychological status.

Saccades of video head impulse test in Meniere's disease and Vestibular Migraine: What can we learn from?

Background:Saccades are often observed on video head impulse tests(vHIT)in patients with Meniere's Disease(MD)and Vestibular Migraine(VM).However,their saccadic features are not fully described.Objective:This study aims to identify the saccades characteristics of MD and VM.Methods:75 VM patients and 103 definite unilateral MD patients were enrolled in this study.First raw saccades were exported and analyzed.The VM patients were divided into left and right based on their ears,while the MD patients were separated into affected and unaffected subgroups based on their audiograms and symptoms.Results:The MD patients have more saccades on the affected side(85%vs.69%),and saccade velocity is more consistent than the contralateral side(shown by the coefficient of variation).The saccades occurrence rates on both sides are similar in VM(77%vs.76%),as are other saccadic parameters.The MD patients have more significant inter-aural differences than the VM patients,manifested in higher velocity(p-value 0.000),earlier arriving(p-value 0.010),and more time-domain gathered(p-value 0.003)on the affected side.Conclusions:Bilateral saccades are commonly observed in MD and VM.In contrast to MD,saccades on VM are subtle,scattered,and late-arrived.Furthermore,the MD patients showed inconsistent saccadic distribution with more velocity-uniform saccades on the affected side.

Investigation of the usefulness of zaleplon at two doses to induce afternoon-sleep under noise interference and its effects on psychomotor performance and vestibular function

Background:Military operation personnel often suffer from sleep difficulty because of their work requirements.In this study,we investigated the efficacy of zaleplon at two doses to induce afternoon-sleep under noise interference and its effects on psychomotor performance and vestibular function; we subsequently established the optimal dosage regimen for military operation personnel.Methods:Twenty-two healthy young male volunteers were recruited for the study.Eight subjects took 10 mg or 15 mg of zaleplon and placebo alternately and then were exposed to noise.Changes in polysomnography(PSG) indices,including sleep latency(SL),sleep efficiency(SE) and sleep structure,were recorded after drug administration.After awakening,the volunteers' subjective judgments of sleep quality and sleepiness were measured.Eight volunteers underwent 3 psychomotor performance tests at a one-week interval,and the psychomotor performance tests were conducted before and after taking zaleplon and placebo.Six volunteers participated in the vestibular function test session,and parameters,including optokinetic nystagmus(OKN),vestibular ocular reflex(VOR),visualvestibular ocular reflex(VVOR) and vestibular ocular reflex fixation suppression(VOR-Fix),were detected by the same experimental design as described above.The data of sleep observations were subjected to one-way variance analysis.Results:Compared with the placebo group,SL was shortened significantly,and the scores of subjective sleep quality and sleep depth were clearly increased in the zaleplon 10 mg group(P<0.05).Moreover,the SE and the percent of REM(rapid eye movement) sleep were increased remarkably in the zaleplon 15 mg group(P<0.01).Furthermore,the SE,percent of REM sleep and scores of subjective sleep depth in the zaleplon 15 mg group were significantly higher than in the zaleplon 10 mg group(P<0.05).The psychomotor performance did not change significantly after ingestion of 10 mg or 15 mg of zaleplon,whereas the OKN and VOR gains were lower in the two dose groups of zaleplon(P<0.05) and restored to normal 3h after drug ingestion.Conclusion:Zaleplon is an ideal hypnotic for military personnel,and its hypnotic efficiency is dose-related under noise interference; a 15 mg dose of zaleplon could provide significantly better sleep than a 10 mg dose of zaleplon.

Analysis of video head impulse test saccades data in patients with vestibular migraine or probable vestibular migraine

Objective:Saccades accompanied by normal gain in video head impulse tests(vHIT)are often observed in patients with vestibular migraine(VM).However,they are not considered as an independent indicator,reducing their utility in diagnosing VM.To better understand clinical features of VM,it is necessary to understand raw saccades data.Methods:Fourteen patients with confirmed VM,45 patients with probable VM(p-VM)and 14 agematched healthy volunteers were included in this study.Clinical findings related to spontaneous nystagmus(SN),positional nystagmus(PN),head-shaking nystagmus(HSN),caloric test and vHIT were recorded.Raw saccades data were exported and numbered by their sequences,and their features analyzed.Results:VM patients showed no SN,PN or HSN,and less than half of them showed unilateral weakness(UW)on caloric test.The first saccades from lateral semicircular canal stimulation were the most predominant for both left and right sides.Neither velocity nor time parameters were significantly different when compared between the two sides.Most VM patients(86%)exhibited small saccades,around 35%of the head peak velocity,with a latency of 200e400 ms.Characteristics of saccades were similar in patients with p-VM.Only four normal subjects showed saccades,all unilateral and seemingly random.Conclusions:Small saccades involving bilateral semicircular canals with a scattered distribution pattern are common in patients with VM and p-VM.

Assessment of Balance and Vestibular Functions in Patients with Idiopathic Sudden Sensorineural Hearing Loss

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.

SLC26A4 mutation testing for hearing loss associated with enlargement of the vestibular aqueduct

nPendred syndrome （PS） is characterized by autosomal recessive inheritance of goiter associated with a defect of iodide organification, hearing loss, enlargement of the vestibular aqueduct （EVA）, and mutations of the SLC26A4 gene. However, not all EVA patients have PS or SLC26A4 mutations. Two mutant alleles of SLC26A4 are detected in 1/4 of North American or European EVA populations, one mutant allele is detected in another 1/4 of patient populations, and no mutations are de-tected in the other 1/2. The presence of two mutant al-leles of SLC26A4 is associated with abnormal iodide or-ganification, increased thyroid gland volume, increased severity of hearing loss, and bilateral EVA. The pres-ence of a single mutant allele of SLC26A4 is associated with normal iodide organification, normal thyroid gland volume, less severe hearing loss and either bilateral or unilateral EVA. When other underlying correlations are accounted for, the presence of a cochlear malformation or the size of EVA does not have an effect on hearing thresholds. This is consistent with observations of an Slc26a4 mutant mouse model of EVA in which hearing loss is independent of endolymphatic hydrops or in-ner ear malformations. Segregation analyses of EVA in families suggest that the patients carrying one mutant allele of SLC26A4 have a second, undetected mutant allele of SLC26A4, and the probability of a sibling hav-ing EVA is consistent with its segregation as an autoso-mal recessive trait. Patients without any mutations are an etiologically heterogeneous group in which siblings have a lower probability of having EVA. SLC26A4 muta-tion testing can provide prognostic information to guide clinical surveillance and management, as well as the probability of EVA affecting a sibling.

INFLUENCE ON VESTIBULAR FUNCTION BY AUDITORY NEUROPATHY

Objective The main purpose of the present study was to describe the vestibular function in patients with auditory neuropathy (AN), and to assess their ability to maintain balance. Methods Vestibular function tests were performed on 32 patients with AN and 36 normal subjects including electronystagmopraphy(ENG) and static postrography(SPG). The results from the two groups were compared. Results Equilibrium function in patients with AN, was abnormal, compared to normal subjects. Conclusion Vestibular function tests, espe-cially static postrography, should be performed on patients with AN.

Evaluation of Vestibular Function in Diagnosis of Vestibular Schwannomas

Vestibular schwannomas(VS)are benign tumors of the vestibular nerve.The common first symptoms are hearing loss and tinnitus,followed by imbalance,vertigo,and facial nerve involvement.The subjective symptoms of VS patients are not consistent with the severity of vestibular lesions and the results of vestibular tests,which often interfere with clinicians’diagnoses.Thus,the main screening and diagnostic methods for VS are audiometry and magnetic resonance imaging(MRI),ignoring the evaluation of vestibular function at the source of pathological lesions.With the development and improvement of vestibular evaluation technology and its wide application in the clinic,modern vestibular examination technology can reflect the severity and frequency of vestibular lesions and compensation from multiple perspectives,providing an objective basis for the diagnosis and treatment of vestibular diseases.In this report,we review the results and characteristics of vestibular tests in VS patients and further clarify the clinical value of vestibular function assessment in the diagnosis and treatment of VS.

The Treatment of Peripheral Vestibular Dysfunction Using Caloric Vestibular Stimulation in Patients with Cerebral Hypertensive Crisis

Background: To verify the efficacy of caloric vestibular stimulation in patients with peripheral vestibular dysfunction after cerebral hypertensive crisis. Methods: Enrolled in the study were 60 patients with peripheral vestibular dysfunction caused by a cerebral hypertensive crisis, docu-mented by vestibulometry. Thirty patients underwent standard treatment plus caloric vestibular stimulation, and 30 control group patients received standard treatment alone. Results: After the two-week treatment course, the sensation of vertigo was observed in 40.0% ± 8.9% of treatment group patients compared with 80.0% ± 7.3% of control group patients (t = 3.46;p < 0.001). Spontaneous vestibular somatic reactions were found in 46.7% ± 9.1% of the study treatment group in contrast to 86.7% ± 6.2% of the control group (t = 3.63;p < 0.001). Spontaneous nystagmus was seen in 40.0% ± 8.9% of treatment group patients compared with 93.3% ± 4.6% of control subjects (t = 5.31;p < 0.001). Spontaneous vestibular vegetative reactions were observed in 33.3% ± 8.6% of patients receiving study treatment in contrast to 93.3% ± 4.6% of control group patients (t = 6.16;p < 0.001). Also, 53.3% ± 9.1% of study treatment group patients showed asymmetry of labyrinths compared with 86.7% ± 6.2% of patients from the control group (t = 3.03;p < 0.001). Conclusion: Caloric vestibular stimulation was shown to be an effective treatment for peripheral vestibular dysfunction in patients with cerebral hypertensive crisis. During the 14-day treatment of cerebral hypertensive crisis, complete labyrinthine function recovery occurred in 46.7% of treatment group patients who underwent caloric vestibular stimulation as opposed to 13.3% of control group patients who received standard treatment alone.

Evaluation of ocular and cervical vestibular evoked myogenic potentials in a conductive hearing loss model

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 (oVEMPs) and cervical VEMPs (cVEMPs) 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: oVEMPs 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, cVEMPs 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 oVEMPs and cVEMPs.

Vestibular Rehabilitation for the Patients with Intractable Vestibular Neuritis

Objective: To clarify whether vestibular rehabilitation is effective in improving spontaneous nystagmus in patients with intractable vestibular neuritis. Methods: The subjects were 8 patients (6 females and 2 males) with vestibular neuritis who revealed long-lasting (more than 2 months since the onset) horizontal spontaneous nystagmus toward the healthy side. We used thumbs-up head shaking for vestibular rehabilitation. This exercise involves active head shaking (1 Hz) while staring at one’s thumb nail. One set is 10 cycles. We asked the patient to do 3 sets (morning, afternoon, and night) every day. Results: The mean value of the slow-phase velocity of spontaneous nystagmus before treatment was 4.1&deg;/s, and that 3 months after vestibular rehabilitation was 4.1&deg;/s. No improvement was observed. Conclusion: Vestibular rehabilitation is not always effective in improving spontaneous nystagmus in patients with intractable vestibular neuritis. Therefore, clinicians should consider the possibility of long-term incomplete central compensation.

前庭功能联合听力学检查在眩晕疾病中的应用研究

背景前庭功能检查项目种类众多,各检查项目靶点及阳性率各有不同,临床上眩晕患者如何恰当合理选择检查项目有不同观点。目的探讨前庭功能联合听力学检查在外周眩晕疾病中的应用价值,为临床眩晕疾病的诊断及鉴别诊断提供参考依据。方法选择2021年1月—2022年1月以头晕或眩晕为主诉就诊于宜宾市第一人民医院眩晕门诊的患者。所有患者在起病7d内完成纯音测听(PTA)、温度试验、视频头脉冲试验(vHIT)、摇头试验(HST),比较不同眩晕疾病的前庭功能及听力学检查的异常率。结果符合纳入、排除标准且病例资料完整的眩晕患者共120例,其中突发性聋伴眩晕(SDV)组、良性阵发性位置性眩晕(BPPV)组、前庭性偏头痛(VM)组各40例。SDV组患者PTA均为感音神经性聋,温度试验异常25例(62.50%),vHIT异常16例(40.00%),HST异常28例(70.00%)。BPPV组患者PTA异常9例(22.50%),其中7耳为感音神经性聋,2耳为传导性聋;温度试验异常18例(45.00%),vHIT异常21例(52.50%),HST异常20例(50.00%)。VM组患者PTA异常21例(52.50%),均为感音神经性聋,其中26耳为高频听力轻中度下降,7耳为低频轻中度下降,温度试验异常16例(40.00%),vHIT异常17例(42.50%),HST异常27例(67.50%)。三组患者PTA检查异常率比较,差异有统计学意义(χ^(2)=50.26,P<0.001);三组患者温度试验、vHIT、HST异常率比较,差异无统计学意义(P>0.05)。结论前庭功能联合听力学检查有助于周围性眩晕的定位诊断及鉴别诊断。

药物治疗联合前庭功能训练对前庭神经炎患者平衡功能、炎症因子及氧化应激水平的影响

目的探讨药物治疗联合前庭功能训练对前庭神经炎患者平衡功能、炎症因子及氧化应激水平的影响。方法前瞻性选取2021年2月至2023年2月唐山市人民医院前庭神经炎患者70例,依据随机数字表法将其分为对照组与训练组,每组各35例。对照组采用醋酸泼尼松、甲磺酸盐酸倍他司汀等药物治疗,训练组在对照组的基础上进行前庭功能训练。比较两组患者治疗前和治疗4周后的眩晕程度[眩晕残障程度评定量表(DHI)]、前庭功能检查参数[半规管轻瘫值(CP)和优势偏向(DP)、自发性眼震角度(SN)]、平衡功能[Berg平衡量表(BBS)、日常活动前庭功能障碍等级量表(VADL)]、前庭功能状态、脑血流速度、炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]及氧化应激[25羟维生素D3(25(OH)D3)、丙二醛、超氧化物歧化酶(SOD)]水平、临床疗效及不良反应发生情况。结果治疗4周后,训练组患者的躯体性、情感性、功能性评分及DHI总分分别为(2.26±0.37)、(2.18±0.34)、(2.02±0.33)、(6.48±1.12)分,均低于对照组,差异均有统计学意义(P<0.05)。治疗4周后,训练组患者的CP、DP、SN分别为(52.75±6.45)%、(23.25±3.46)%、(0.35±0.10)°/s,均低于对照组,差异均有统计学意义(P<0.05)。治疗4周后,训练组的BBS评分为(32.36±3.02)分,明显高于对照组,VADL评分为(28.65±4.12)分,明显低于对照组,差异均有统计学意义(P<0.05)。治疗4周后,训练组的血清IL-6、TNF-α、CRP水平分别为(12.30±1.57)g/mL、(11.41±1.05)pg/mL、(10.24±2.05)mg/L,均明显低于对照组,差异均有统计学意义(P<0.05)。治疗4周后,训练组血清25(OH)D3、SOD水平为(22.03±3.02)ng/mL、(65.67±6.43)U/mL,高于对照组,丙二醛水平分别为(3.97±0.35)nmoL/mL,均明显低于对照组,差异均有统计学意义(P<0.05)。治疗4周后,训练组的基底动脉、左椎动脉、右椎动脉血流速度分别为(36.01±1.55)、(33.44±1.62)、(34.60±2.17)cm/s,均明显高于对照组,差异均有统计学意义(P<0.05)。训练组患者的总有效率为91.43%,明显高于对照组(71.43%),差异有统计学意义(P<0.05)。两组患者的总不良反应发生率比较,差异无统计学意义(P>0.05)。结论药物治疗联合前庭神经炎治疗中前庭功能训练能够提升患者的平衡功能,改善炎症因子及氧化应激水平,值得临床推广应用。

前庭功能训练操在眩晕患者康复护理中的应用

目的观察前庭功能训练操在眩晕患者康复护理中的应用效果,以及对前庭症状指数(vestibular symptom index,VSI)、伯格平衡量表评分(Burger balance scale,BBS)的影响。方法选取2022年1月—2023年11月在厦门大学附属第一医院接受治疗的80例眩晕患者为研究对象。按护理方式的不同分为2组,各40例。对照组予以常规护理措施,观察组在对照组的基础上给予前庭功能训练操,护理持续1个月。对比2组患者干预前后的VSI、BBS、负性情绪(state anxiety scale,SAI)、生活质量(quality of life-74,GQOL-74)、护理满意度。结果干预后,观察组VSI评分为(18.17±5.20)分,低于对照组的(24.79±5.46)分,差异有统计学意义(P<0.05)。干预后,观察组BBS评分为(48.18±5.12)分,高于对照组的(41.77±5.63)分,差异有统计学意义(P<0.05)。干预后,观察组的SAI评分低于对照组,GQOL-74各维度评分高于对照组,差异有统计学意义(P<0.05)。观察组的护理总满意度为97.50%(39/40),高于对照组的80.00%(32/40),差异有统计学意义(P<0.05)。结论眩晕患者应用前庭功能训练操可显著改善患者的前庭症状,调节其平衡能力,患者焦虑情绪明显得到缓解,从而改善其生活质量水平,患者对护理工作的满意度较高。

颏下前庭联合入路ETS对PTC患者的临床疗效及安全性评价

目的:通过分析围手术期应激反应、术后并发症发生率,探讨颏下前庭联合入路腔镜甲状腺手术(ETS)治疗甲状腺乳头状癌(PTC)的疗效及安全性。方法:选取2020年1月至2023年10月昆明医科大学第一附属医院114例PTC患者,以随机数字表法分为两组,各57例。对照组予以口腔前庭入路ETS,观察组予以颏下前庭联合入路ETS。对比两组手术相关指标、术后疼痛程度、围手术期应激指标、甲状旁腺素(PTH)与血钙水平、免疫功能指标(CD3+、CD4+、CD8+、CD4+/CD8+)、术后并发症发生率。结果:观察组术中出血量、术后引流量、手术时间、引流管留置及住院时间分别为(21.53±2.69)mL、(33.52±3.09)mL、(60.54±9.12)min、(2.74±0.89)d、(4.67±1.25)d,均少于对照组的(24.59±4.37)mL、(36.14±4.18)mL、(80.96±11.23)min、(3.32±1.04)d、(6.49±1.37)d,差异有统计学意义(t=4.502、3.805、10.657、3.199、7.409,P均<0.05);观察组术后4h、12h、24h、48h疼痛VAS评分分别为(2.11±0.65)分、(2.84±0.78)分、(2.34±0.78)分、(1.34±0.40)分,低于对照组的(2.63±0.80)分、(3.31±0.87)分、(2.89±0.82)分、(1.92±0.58)分,差异有统计学意义(t=3.809、3.037、3.669、6.215,P均<0.05);术后24h、72h观察组NE水平分别为(0.64±0.12)mmoL/L、(0.41±0.07)mmoL/L,低于对照组的(0.72±0.15)mmoL/L、(0.46±0.09)mmoL/L,Cor分别为(76.92±12.33)μg/L、(52.12±5.27)μg/L,低于对照组的(85.46±15.02)μg/L、(58.14±7.12)μg/L,差异有统计学意义(t=3.144、3.311、3.318、5.131,P均<0.05);术后24h、72h观察组PTH分别为(4.65±1.08)pmoL/L、(5.15±0.70)pmoL/L,高于对照组的(4.08±1.24)pmoL/L、(4.81±0.82)pmoL/L,血钙水平高于对照组分别为(2.15±0.09)mmoL/L、(2.22±0.07)mmoL/L,高于对照组的(2.04±0.12)mmoL/L、(2.17±0.09)mmoL/L,差异有统计学意义(t=2.617、2.381、5.537、3.311,P均<0.05);术后7d、1个月观察组CD3+、CD4+及CD4+/CD8+分别为(61.33±4.06)%、(68.74±4.27)%、(32.94±3.02)%、(43.98±2.27)%、(1.14±0.12)、(1.76±0.17),高于对照组的(59.07±3.85)%、(63.24±3.89)%、(28.89±2.74)%、(36.72±2.05)%、(0.93±0.10)、(1.34±0.15),CD8+分别为(29.01±2.45)%、(25.02±2.13)%,低于对照组的(31.14±3.02)%、(27.46±2.77)%,差异有统计学意义(t=3.050、7.189、7.498、17.920、4.135、5.272、10.150、13.986,P均<0.05);观察组术后并发症发生率3.51%低于对照组的15.79%(χ2=4.930,P<0.05)。结论:颏下前庭联合入路ETS治疗PTC创伤小,术后恢复快,并发症少,可减轻炎症反应,缓解疼痛,促进免疫功能恢复。

良性阵发性位置性眩晕患者的耳石器及半规管功能分析

目的探讨良性阵发性位置性眩晕(BPPV)对耳石器及半规管功能的影响及其可能的发病因素。方法选择2022年12月-2023年6月本院收治的单管良性阵发性位置性眩晕患者作为研究对象,分别行视频头脉冲试验(vHIT)、前庭肌源诱发电位(VEMP)、听性脑干反应(ABR),分析其检测结果。结果后半规管BPPV患者与水平半规管BPPV患者vHIT、cVEMP、oVEMP、ABR检查结果异常侧别分布情况比较,差异无统计学意义(P>0.05),但在老年水平半规管BPPV患者的oVEMP双侧异常率(41.2%)比后半规管BPPV患者的oVEMP双侧异常率(10.3%)高,两组差异存在统计学意义(P<0.05)。青中年BPPV患者的ABR双侧异常率(15.2%)低于老年BPPV患者的ABR双侧异常率(33.9%),差异存在统计学意义(P<0.05);青中年BPPV患者与老年BPPV患者vHIT、cVEMP、oVEMP检查结果异常侧别分布情况比较,差异无统计学意义(P>0.05)。结论BPPV可见于半规管弥漫性损伤,内耳循环障碍可引起耳石器功能障碍,其可能是BPPV的发病因素。

前庭性偏头痛患者认知功能测评及眼震视图分析

目的测评前庭性偏头痛(VM)患者认知功能水平,分析、探讨眼震视图(VNG)在VM患者认知功能中的评估价值。方法选择2022年3月—2023年6月在启东市人民医院诊疗的60例VM患者为研究对象(VM组),同期纳入无眩晕、偏头痛或其他神经系统疾病的60例正常者作为对照(NC组)。采用简易精神状态评价量表(MMSE)、蒙特利尔认知评估量表(MoCA)来评估VM组和NC组的总体认知水平,并使用重复性神经心理状态评定量表(RBANS)进行神经心理及多领域认知功能的全面测评,利用VNG观察VM患者眼动特征。结果与NC组相比,VM组患者轻度认知障碍(MCI)的发生率明显增加,MoCA评分显著降低,差异具有统计学意义(P<0.01);在即刻记忆、视觉广度、语言功能、注意力、延时记忆、处理速度和执行功能多个认知域均存在明显受损,差异具有统计学意义(P<0.05);与NC组相比,VM组患者MMSE评分偏低,但差异无统计学意义(P>0.05)。从VNG结果分析,VM组患者扫视试验、平稳跟踪试验、视动试验、位置性眼震的发生率均高于NC组,差异具有统计学意义(P<0.05);而自发性眼震、凝视试验的发生率与NC组相比差异无统计学意义(P>0.05)。结论VM患者认知功能损害较明显,体现在记忆力、语言能力、视觉广度、注意力、处理速度及执行功能等方面;分析VNG特征,发现前庭系统对VM患者的认知功能有显著影响。

前庭康复对缓解创伤性颅脑损伤患者眩晕效果的meta分析

目的 探讨前庭康复是否有助于缓解创伤性颅脑损伤(TBI)患者眩晕症状。方法 计算机检索国内外数据库有关TBI患者使用前庭康复的随机对照研究,检索时限为建库至2023年6月1日,采用Revman 5.3软件进行统计分析。结果 共纳入7项研究,共计330名TBI患者。Meta分析结果显示,对TBI患者进行前庭康复有助于缓解眩晕症状[MD=-3.79,95%CI-5.13,-2.45,P<0.05]和焦虑抑郁情绪[MD=-0.76,95%CI(-1.34,-0.17),P<0.05],能改善其平衡功能[SMD=-0.59,95%CI(-0.94,-0.23),P<0.05]和前庭功能[MD=-3.36,95%CI(-6.38,-0.35),P<0.05],并对缓解轻度TBI患者脑震荡后症状也有一定效果[SMD=-0.55,95%CI(-0.89,-0.21),P<0.05]。结论 前庭康复能缓解TBI患者眩晕症状和焦虑抑郁情绪,可改善平衡功能和前庭功能,并可缓解轻度TBI患者脑震荡后症状,日后可将前庭康复加入到颅脑损伤患者康复方案中。

某高校建筑类专业学生眩晕发病危险因素的调查研究

目的:探索建筑专业学生眩晕的相关风险因素,为降低未来高空作业的坠落事件提供依据。方法:本研究选取了湖北职业技术学院2022年9月至2023年6月期间在校建筑类专业学生为研究对象。根据人口学信息、临床特征、PHQ-9评测结果及眼震视图检查结果,以多因素回归分析探索眩晕相关的风险因素。结果:研究纳入541名参与者,234人(43.25%)有眩晕病史,其中女性比例高于男性,抑郁症状在眩晕患者中更常见。多因素回归分析显示:心理状态,双温试验、疲劳及睡眠障碍与眩晕发病显著相关。结论:前庭功能异常、抑郁、疲劳状态及睡眠障碍与眩晕发病相关,对建筑专业学生进行前庭功能普查、心理及疲劳状态评估有助于降低高空作业时的安全风险。

急性前庭综合征患者脑梗死的临床特征及相关因素分析

背景急性脑梗死是急性前庭综合征中较为危重的疾病。急性前庭综合征患者起病急,症状重,CT诊断急性脑梗死的灵敏度低,而核磁共振检查又不易立即实施,这使得表现为急性前庭综合征的急性脑梗死诊断具有一定挑战性,因此有必要探究适用于急性前庭综合征患者的检查和评价方法。目的分析急性前庭综合征患者中急性脑梗死发生的相关危险因素,为急性前庭综合征中急性脑梗死的诊断提供借鉴,争取急性脑梗死患者的黄金治疗时间。方法收集2021年4月—2022年7月就诊于哈尔滨医科大学附属第四医院神经内科急性前庭综合征患者102例,录入相关临床体征,以核磁共振检查结果作为脑梗死诊断的金标准,分为脑梗死组(16例)与非脑梗死组(86例),对比两组患者临床特点,采用单因素和多因素Logistic回归分析探究急性前庭综合征中脑梗死发生的相关影响因素,并绘制受试者工作特征(ROC)曲线评价相关影响因素对脑梗死的预测价值。结果脑梗死组患者吸烟史、饮酒史、头脉冲试验-眼震-眼位偏斜试验(HINTS)阳性比例、ABCD2评分均高于非脑梗死组(P<0.05)。单因素Logistic回归分析显示HINTS阳性、ABCD2评分、吸烟史、饮酒史、听力下降是脑梗死发生的影响因素(P<0.05),多因素Logistic回归分析显示HINTS阳性(OR=99.043,95%CI=8.120~1208.090)和ABCD2评分(OR=2.820,95%CI=1.188~6.696)是脑梗死发生的影响因素(P<0.05)。多指标联合、HINTS阳性、ABCD2评分、吸烟史、饮酒史、听力下降预测脑梗死的ROC曲线下面积(AUC)为0.949、0.874、0.734、0.643、0.649和0.604。结论急性前庭综合征患者中非脑梗死比例较大,其中以前庭神经炎最常见,HINTS阳性和ABCD2评分与急性前庭综合征中脑梗死的发生密切相关。