动态平衡仪在良性阵发性位置性眩晕患者平衡功能评价及康复治疗中的应用价值

目的 探讨动态平衡仪在良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)患者平衡功能评价及康复治疗中的应用价值.方法 回顾性分析2007年5月至2008年12月48例后半规管BPPV患者的临床资料.所有患者分别于Epley法复位前后行动静态平衡仪及冷热试验检查,并对结果进行分析比较.对于复位后眼震消失但仍有平衡障碍的患者采用动态平衡仪进行平衡康复训练,3周后再行动态平衡仪检查.结果 48例BPPV患者,Epley法复位前,冷热试验异常12例,占25.O%;静态平衡仪异常16例,占33.3%;动态平衡仪异常34例,占70.8%.经统计分析,动态平衡仪异常率高于冷热试验及静态平衡仪,差异具有统计学意义(χ2值分别为4.84和7.88,P值均＜O.05).Epley法复位治疗后,冷热试验异常7例,静态平衡仪异常4例,动态平衡仪异常8例.复位治疗后动态及静态平衡仪测试结果异常率明显降低,差异具有统计学意义(χ2值分别为24.04和1O.08,P值均＜0.05);而冷热试验结果无明显变化,治疗前后差异无统计学意义(χ2=3.2,P＞0.05).运用动态平衡仪对复位治疗后仍有平衡障碍的8例患者进行平衡康复训练,3周后所有患者平衡不稳感均消失,复查动态平衡仪结果均正常.结论 动态平衡仪可定量分析姿势平衡状态,有助于全面评价BPPV患者的平衡功能;BPPV患者多伴有平衡功能的降低,Epley法复位治疗可改善大部分患者的平衡功能,但并非所有患者平衡功能均恢复正常.运用动态平衡仪进行平衡康复训练对于已行耳石复位但仍有平衡障碍的患者有益.     

Vestibular function after cochlear implant surgery

Objective: The aim of this study was to analyze vestibular function in cochlear implant (CI) patients for iatrogenic damage to vestibular function.

Methods: Prospective clinical study. Tertiary care audiological center. Twenty-five subjects receiving surgery for cochlear implantation during 2012 and 2013 were analyzed. Both vestibulo-ocular and vestibulo-spinal responses before and 2 months after CI surgery were evaluated using several tests: analysis of spontaneous nystagmus, head shaking test (HST), and head impulse test recorded by videooculography; caloric stimulation at 44° and 30° in both ears; cervical evoked myogenic potentials and static stabilometry. Residual cochlear function was tested by air-conduction pure-tone audiometry.

Results: Our tests showed damage to vestibular receptors after CI surgery in 12% of the patients; in particular, horizontal semicircular canal function and saccular function had lower responses after surgery. Audiometric results showed poorer thresholds after CI surgery. The static stabilometry results indicate good vestibulo-spinal responses and patients did not report disequilibrium nor postural deficit.

Conclusion: All data suggest an efficient vestibular compensation mechanism in CI patients.     

VEMPs and dynamic posturography after intratympanic gentamycin in Menière's disease

In this study, we investigated whether vestibular evoked myogenic potentials (VEMPs) and dynamic posturography (DP) are useful in the evaluation of the vestibular function in patients affected by active monoaural Menière's disease (MD) treated with intratympanic gentamycin. Twelve subjects affected by monoaural MD were treated with weekly intratympanic injections of 0.5 ml of gentamycin at a concentration of 20 mg/ml. VEMPs were used to test saccular function, while postural control was analyzed by DP. The results obtained with these two techniques were compared with those obtained by using bithermal caloric test. The mean follow-up was 15.3 months (6--28 months). Therapy resulted in complete absence of the caloric response in six subjects (50) and in caloric test-induced asymmetry in the remaining individuals, ranging from 83 to 27. At follow-up, eleven patients (91.6%) were free of vertigo, while one patient had two vertigo spells 9 months after treatment. Before treatment, VEMPs were present in the affected ear of eleven patients. After treatment VEMPs were absent in all the patients. At the end of follow-up, reappearance of VEMPs was observed in two patients, with no changes in latency values and amplitude ratio. DP demonstrated a reduction of the Composite Score (CS) one week after therapy, with a prevalent reduction of the vestibular component. After 6 months, there was an improvement of the CS and, in particular, of the vestibular component. The present study demonstrates that bithermal caloric test and VEMPs allow for the functional evaluation of both the horizontal semicircular canal and the sacculus, suggesting that these techniques might be used together to monitor the efficacy of intratympanic gentamycin therapy. In addition, our data indicate that DP might provide important information on compensation phenomena and show that intratympanic gentamycin can improve postural control in MD patients.     

Validity and limitation of detection of peripheral vestibular imbalance from analysis of manually rotated vestibulo-ocular reflex recorded in the routine vestibular clinic

We compared the results of analysis of vestibulo-ocular reflex (VOR) obtained by manual rotation in routine vestibular clinical practice with that of caloric testing, and examined the validity and limitations of VOR analysis as a test for the estimation of peripheral vestibular function and imbalance. VOR response was recorded in daily vestibular clinical examinations by manually rotating the standard clinical chair for approximately 30 s. VOR gain was slightly, but significantly, correlated with the peak slow phase velocity of caloric response (r = 0.50, p < 0.001). However, 8 out of 12 patients with no caloric response failed to exceed the range of two standard deviations of the mean value of age-matched normal subjects, indicating that it is clinically difficult to use VOR gain alone as a estimate of unilateral vestibular function. VOR directional preponderance (VOR DP%) correlated well with caloric canal paresis (CP) (CP%; r = 0.89, p < 0.001). VOR DP% was within the normal range in patients with caloric CP% < 40 and exceeded the normal range in most cases with caloric CP% > 80. VOR DP% varied widely when caloric CP% ranged between 40 and 80. The effect of vestibular compensation on VOR DP% was examined by plotting VOR DP% divided by caloric CP% (DP/CP) against the number of days since the onset of vertigo in patients with vestibular neuritis or sudden deafness with vertigo. DP/CP was large within 50 days of the onset of vestibular damage, especially when caloric CP% was < 80, and gradually decreased with time. These results indicate that determination of VOR DP% should contribute to the early diagnosis of fresh vestibular imbalance, especially in daily clinical practice, because this type of VOR recording can be performed in < 1 min in routine vestibular clinics. The decay time constant of DP/CP was larger when caloric CP% exceeded 80, indicating that vestibular compensation proceeds more slowly when the vestibular damage is severe.     

Vestibular and audiologic functions in gentamicin-treated Menière's disease

Fifteen patients with disabling Meniere's disease were treated with local intratympanic administration of gentamicin once daily. They had suffered from frequent attacks of vertigo and vomiting, the hearing in the affected ears was decreased permanently, and spontaneous nystagmus was observed. The number of treatment days ranged between 3 and 11. Follow-up time was 1 to 6 years. For evaluation of the treatment, audiologic and vestibular examinations were used, including the broad frequency-band rotatory test (0.4-4.5 Hz). Fourteen patients were free from vertigo after treatment. In 5 patients, there was an increased hearing loss, and in 10 it remained unchanged. Tinnitus and fullness sensations were diminished. After treatment, all ears were unresponsive to caloric stimulation. The clinical examination and rotatory testing in light with sinusoidal stimulation revealed good central compensation of the vestibular loss. However, with pseudorandomized oscillations in darkness, the broad frequency-band rotatory test quantified the loss of peripheral vestibular function and was able to detect the side of the lesion in eight of nine patients.     

Validity and Limitation of Detection of Peripheral Vestibular Imbalance from Analysis of Manually Rotated Vestibulo-Ocular Reflex Recorded in the Routine Vestibular Clinic

We compared the results of analysis of vestibulo-ocular reflex (VOR) obtained by manual rotation in routine vestibular clinical practice with that of caloric testing, and examined the validity and limitations of VOR analysis as a test for the estimation of peripheral vestibular function and imbalance. VOR response was recorded in daily vestibular clinical examinations by manually rotating the standard clinical chair for &#44 30 s. VOR gain was slightly, but significantly, correlated with the peak slow phase velocity of caloric response ( r = 0.50, p < 0.001). However, 8 out of 12 patients with no caloric response failed to exceed the range of two standard deviations of the mean value of age-matched normal subjects, indicating that it is clinically difficult to use VOR gain alone as a estimate of unilateral vestibular function. VOR directional preponderance (VOR DP%) correlated well with caloric canal paresis (CP) (CP%; r = 0.89, p < 0.001). VOR DP% was within the normal range in patients with caloric CP% < 40 and exceeded the normal range in most cases with caloric CP% > 80. VOR DP% varied widely when caloric CP% ranged between 40 and 80. The effect of vestibular compensation on VOR DP% was examined by plotting VOR DP% divided by caloric CP% (DP CP) against the number of days since the onset of vertigo in patients with vestibular neuritis or sudden deafness with vertigo. DP CP was large within 50 days of the onset of vestibular damage, especially when caloric CP% was < 80, and gradually decreased with time. These results indicate that determination of VOR DP% should contribute to the early diagnosis of fresh vestibular imbalance, especially in daily clinical practice, because this type of VOR recording can be performed in < 1 min in routine vestibular clinics. The decay time constant of DP CP was larger when caloric CP% exceeded 80, indicating that vestibular compensation proceeds more slowly when the vestibular damage is severe.     

Caloric response and postural control in patients with nasopharyngeal carcinoma after radiotherapy

Since radiotherapy is the treatment of choice for nasopharyngeal carcinoma, the influence of irradiation on the temporal bone is of great concern for these patients. In this study, the caloric test and posturography were used to investigate vestibular function in 41 irradiated patients with nasopharyngeal carcinoma. Caloric testing showed a high incidence of canal paresis; five unilateral and 10 bilateral. Factors such as middle ear effusion had no significant effect on the occurrence of canal paresis. Posturography showed no difference from the control group. The authors conclude that the influence of irradiation on the vestibular apparatus of patients with nasopharyngeal carcinoma might result in a canal paresis, while postural control is preserved. Central compensation may play an important role in the postural control of these patients.     

Caloric test as a predictor tool of postural control in CI users

Conclusions: Balance was improved at 365 days after CI in all patients. Caloric test findings were important determinants of balance outcomes over a year after CI. Pre-operative vestibular assessment findings should be documented because postural recovery over time depends on this information. Objective: To verify the importance of the caloric test as a pre-operative predictor tool of postural control after CI surgery. Methods: Prospective observational study made with 24 post-lingual deafness patients who underwent unilateral CI surgery. Vestibular assessments: questionnaire assessing vertigo, caloric tests, rotary chair (RC) testing, and computerized dynamic posturography (CDP), were sequentially performed for all patients before and 60, 120, 180, and 365 days after CI. Results: Thirteen patients (54.2%) reported dizziness before CI. At the end of the study, dizziness remained unchanged in one (7.7%) patient, ameliorated in 11 (84.6%), and worsened in one (7.7%). Baseline caloric tests identified 29.2% patients with normal reflexes, 33.3% with unilateral areflexia or hyporeflexia, 12.5% with bilateral hyporeflexia, and 25% with bilateral vestibular loss (BVL). Most patients exhibited objective improvements in postural stability. At 365 days, the CDP condition (particularly C5) and CS were higher for caloric tests responders at baseline than for those with BVL at baseline.     

Vestibular system in infants after systemic aminoglycoside therapy

OBJECTIVES: The ototoxic action of systemic therapy with aminoglycoside antibiotics leading to the loss of inner ear hair cells is well recognized. The mitochondria-mediated pathway of apoptosis may play a role in inducing the apoptosis of vestibular hair cells due to aminoglycoside toxicity. Aminoglycosides are, nevertheless, routinely used for treatment of vital infections in neonatologic departments. Although there is a strong supposition that aminoglycosides can influence the vestibular function in infants, the routine examination of the infants' inner ear does not include vestibular tests. The purpose of the present study was to evaluate vestibular function in a group of infants prior to and after administration of systemic aminoglycosides, using caloric tests and vestibular-evoked myogenic potentials (VEMPs). METHODS: VEMPs and auditory brainstem responses were recorded and caloric stimulation was performed in 68 infants aged 2.5-3.5 months: 40 healthy controls and 28 infants after therapy with amikacin, 15mg/(kgday) in three doses. The therapy duration varied from 10 to 14 days. In 18 infants antibiotic therapy was administered for a respiratory infection, and in 10 for sepsis. Infants with other risk factors of inner ear damage and treated with more than one ototoxic drug were excluded from the study. The tests were performed on the day of admission to hospital and repeated on the day of discharge. RESULTS: The results of all tests were normal on admission. On the day of discharge, no reaction to caloric stimulation was elicited in six patients and no VEMPs were recorded in four subjects. Hearing thresholds were normal in all the individuals during both examinations. CONCLUSIONS: The vestibular organ in infants after systemic therapy with amikacin may be damaged more frequently than the cochlear organ. The horizontal canal is more vulnerable to aminoglycosides, as compared to the saccule. The vestibular organ should be routinely examined in infants after systemic treatment with aminoglycosides.     

全聋型突发性耳聋患者的预后与前庭症状及前庭功能关系的回顾性分析

目的 探讨全聋型突发性耳聋患者的预后与前庭症状及前庭功能的关系。 方法 回顾性分析52例单侧全聋型突发性耳聋患者的前庭症状,以及眼肌前庭诱发肌源性电位(oVEMP)、颈肌前庭诱发肌源性电位(cVEMP)、视频头脉冲试验(vHIT)和冷热试验结果,观察这些患者的听力结果与前庭症状及前庭功能的关系。 结果 在52例单侧全聋型突发性耳聋患者中,有前庭症状、前庭功能异常的全聋型患者与无前庭症状者、功能正常者相比疗效差异有统计学意义。oVEMP、cVEMP、vHIT和冷热试验四项结果异常的全聋型患者显示出更低的治疗总有效率,oVEMP、cVEMP、vHIT和冷热试验正常的突发性耳聋患者有更高的听力恢复数值。 结论 有前庭症状、前庭功能异常的全聋型突发性耳聋患者疗效较差,oVEMP、cVEMP、vHIT和冷热试验正常的全聋型突发性耳聋患者有更好的听力恢复。前庭功能异常提示突发性聋患者的内耳病变范围较大、程度较重。     

Abnormal deviation of subjective visual horizontal in patients with vestibular schwannoma

OBJECTIVES: This study was aimed to examine the correlation between the results of subjective visual horizontal (SVH) and other vestibular function tests in patients with untreated unilateral vestibular schwannoma (VS). METHODS: The subjects comprised 40 consecutive patients (17 men, 23 women) with VS who underwent vestibular function tests before surgery and had surgically and histopathologically confirmed unilateral VS. The vestibular function tests included SVH, caloric, and vestibular evoked myogenic potential (VEMP) tests. RESULTS: Of the 40 patients, 31 (77.5%) showed deviation of the SVH toward the affected side down. Especially in 8 patients (20.0%), abnormal deviation (more than 2.2 degrees) toward the affected side down was seen. None of the patients showed abnormal deviation toward the unaffected side down. On the caloric test, the proportion of absent caloric responses and the percent canal paresis in patients with an abnormal SVH was significantly higher than those in patients with a normal SVH. The proportion of abnormal VEMP responses was higher and the percent VEMP asymmetry was smaller in patients with an abnormal SVH than in patients with a normal SVH; however, the differences were not significant. CONCLUSIONS: Abnormal results on the caloric test and/or VEMP test were more frequently seen in VS patients with abnormal deviation of the SVH.     

眼震电图与动态姿势图在良性阵发性位置性眩晕中的临床应用

目的:探讨眼震电图(ENG)及动态姿势描记(DPG)2种前庭功能检查在良性阵发性位置性眩晕(BPPV)中的临床应用。方法:应用ENG与DPG对40例34～79岁的原发性BPPV患者(BPPV组)和20例正常者(对照组)进行检查,其中DPG评定参数选取感觉器官测试(SOT)中前庭感觉评分、本体感觉评分、视觉评分、Romber′s评分和综合评分。结果:40例BPPV患者的ENG检查中,温度试验异常者26例(65.0%);DPG异常者33例(82.5%),并且DPG中均表现为前庭觉评分低,其他几项评分均未见差别。温度试验和DPG两项结果均异常者24例(60.0%),温度试验正常患者中有9例(64.3%)出现前庭觉评分低,在SOT中除前庭觉评分低外其他几项评分均未见明显异常。此外,与对照组比较BPPV组ENG中温度试验和DPG的前庭评分明显异常(P<0.05),并且≥12个月患者上述检查异常程度更高(P<0.05)。结论:ENG与DPG是重要的前庭功能检查方法,二者联合应用能够全面分析BPPV患者前庭功能病变,且BPPV患者病程直接影响其前庭功能。     

Vision preference in dynamic posturography analysed according to vestibular impairment and handicap

OBJECTIVE: The objective of this work was to characterise the implications of vision preference derived from the sensory organisation test of computerised dynamic posturography, in terms of impairment, disability and handicap. MATERIAL AND METHOD: This was a prospective assessment of 88 patients suffering from dizziness who denied experiencing any visually induced vertiginous symptoms. The level of impairment of each patient was estimated by performing a complete analysis of vestibular function by means of the caloric and rotatory stimulation tests. Disability and handicap were determined with the Dizziness Handicap Inventory questionnaire (DHI). RESULTS: The results of the caloric test in patients were independent of vision preference although canal paresis was more frequently abnormal in patients without visual preference. No differences were found in the results of rotatory stimulation by means of impulse and sinusoidal tests, both at high velocities of stimuli, in between patients with and without vision preference. Similarly, the responses in the DHI, a common questionnaire for vestibular disability and handicap and, specifically to questions addressing the problem of visual and vestibular disability, were not able to differentiate either group of patients. Nevertheless, we have found that patients with vision preference tend to have poorer balance. CONCLUSION: We consider that in the patients studied here, vision preference must be considered as a normal finding as this represents a normal strategy in a subject that relies more heavily on visual cues for his or her postural control.     

Short and long-term postural learning to withstand galvanic vestibular perturbations

We investigated changes of postural responses to repeated bipolar galvanic vestibular stimulation on 5 consecutive days and once again after 3 months. Subjects consisted of 21 healthy volunteers. Except for the first day did the induced torque variance in response to galvanic vestibular stimulation not decrease within each test session, but there was a major reduction from day to day (p< 0.001) reflecting a continued processing of the postural experience gained during the stimulation. The decreased end level magnitude of postural responses after 5 days was retained after 3 months. The galvanic stimulation failed to induce larger torque variance compared to quiet stance toward the end of the 5 days as well as after 3 months, indicating a down-regulation of a repeated erroneous vestibular stimulation by the postural control system - i.e. sensory reweighting. This argues that a major adaptation effect to galvanic vestibular perturbation takes place after the exposure to the stimulation - similar to the concept of the consolidation process involved in motor learning. This should be considered when repeatedly assessing vestibular function both clinically and in studies. It implies that sensory training involved in rehabilitation from vestibular diseases/deficiencies should be executed with spaced intervals in order to procure more efficient learning processes and in the end, a better function.     

Vestibular pathophysiologic changes in experimental perilymphatic fistula.

An animal model of experimental perilymphatic fistula (EPLF) was developed in the guinea pig in order to study vestibular pathophysiology. In experimental animals, 4 microL of perilymph was suctioned from one cochlea via the round window membrane. Changes in vestibular function were as follows. 1) During the acute stage (5 hours postoperatively), spontaneous nystagmus directed toward the normal side was noted in 57.4% of the EPLF animals. This lasted less than 24 hours. 2) One week postoperatively, direction-fixed positional nystagmus toward the lesioned ear was present in 22.7% of the EPLF animals, especially when the lesioned ear was positioned inferiorly. 3) With the ice water caloric test, no response was present in 58.1% of the EPLF animals and an irregular response was found in 22.6% of them, 1 week postoperatively. These results tend to indicate that tests of vestibular function may differentiate between patients with Meniere's disease and those with perilymphatic fistula. Histologic findings indicate that a floating labyrinth is the cause of positional nystagmus and caloric irregularity. The absence of caloric responses was associated with collapse of the vestibular labyrinth.     

Influence of aging over 10 years on auditory and vestibular functions in three patients with auditory neuropathy

The influence of aging on hearing and vestibular function in patients with auditory neuropathy has not been investigated. The purpose of this study was to investigate how hearing and vestibular function in this disease change with aging. The subjects were three female patients with auditory neuropathy. We checked their hearing and vestibular function by speech discrimination tests, ABR, ECochG, DPOAE, caloric test, damped-rotational chair test, and VEMPs. In all three patients, speech discrimination ability and vestibular function markedly declined with aging. However, speech language understanding and higher brain function were less affected by aging.     

Galvanic-Induced Postural Movements As a Test of Vestibular Function in Humans

Galvanic stimulation produces postural sway and eye movements in humans. Since galvanic currents are thought to exert their effect at the trigger zone of the vestibular nerve, an intact vestibular nerve should be necessary to produce a response. We have used galvanic stimulation in humans to test the hypothesis that intact vestibular nerve fibers are required to obtain a postural sway response. Experimental subjects included normal subjects, patients who had undergone resection of an acoustic neuroma, and patients who had undergone vestibular neurectomy and surgical labyrinthectomy. Our results support the hypothesis that an intact vestibular nerve is necessary to produce a response. Moreover, two patients with recurrent vertigo following vestibular neurectomy and labyrinthectomy, who had absent ice-water caloric test responses in the operated ears, were found to have a positive galvanic response. This result suggested that their recurrent vertigo was based on intact residual vestibular nerve fibers. Although previous research has not yielded a routine clinical use for galvanic stimulation, our results suggest that galvanic stimulation of the vestibular system can provide unique and valuable diagnostic information.     

Correlation between bithermal caloric test results and vestibular evoked myogenic potentials (VEMPs) in normal subjects

Bithermal caloric testing and vestibular evoked myogenic potentials (VEMPs) are both diagnostic tools for the study of the vestibular system. The first tests the horizontal semicircular canal and the second evaluates the saccule and lower vestibular nerve. The results of these two tests can therefore be expected to be correlated. The aim of this study was to compare bithermal caloric test results with VEMP records in normal subjects to verify whether they are correlated. Material and method: A prospective study was conducted in 60 healthy subjects (30 men and 30 women) who underwent otoscopy, pure tone audiometry, bithermal caloric testing and VEMPs. From the caloric test, we assessed the presence of possible vestibular hypofunction, whether there was directional preponderance and reflectivity of each ear (all based on both slow phase velocity and nystagmus frequency). The analysed VEMPs variables were: p1 and n1 latency, corrected amplitude, interaural p1 latency difference and p1 interaural amplitude asymmetry. We compared the reflectivity, hypofunction and directional preponderance of the caloric tests with the corrected amplitudes and amplitude asymmetries of the VEMPs. No correlations were found in the different comparisons between bithermal caloric testing results and VEMPs except for a weak correlation (p = 0.039) when comparing preponderance based on the number of nystagmus in the caloric test and amplitude asymmetry with 99 dB tone burst in the VEMPs test. The results indicate that the two diagnostic tests are not comparable, so one of them cannot replace the other, but the use of both increases diagnostic success in some conditions.     

Symptomatic high frequency/acceleration vestibular loss: consideration of a new clinical syndrome of vestibular dysfunction

CONCLUSION: Symptomatic high frequency/acceleration vestibular loss is a distinct clinical entity that can be missed on conventional ENG with caloric testing. Under certain circumstances, symptomatic patients with a high frequency/acceleration vestibular loss should undergo an MSSC study for confirmation, if required. OBJECTIVE: To document that normal electronystagmography (ENG) with conventional bithermal caloric testing is inadequate for diagnosing clinically significant high frequency/acceleration vestibular loss. MATERIAL AND METHODS: Patients with clinical symptoms and signs of persistent peripheral vestibular dysfunction despite normal conventional bithermal caloric testing on ENG underwent high frequency/acceleration horizontal magnetic scleral search coil (MSSC) eye movement studies. The clinical findings and results from audiometric tests, conventional ENG with bithermal caloric tests and MSSC tests were reviewed. RESULTS: Eleven patients were identified as having an abnormal MSSC study, indicating a high frequency/acceleration vestibular loss consistent with their clinical history despite normal or equivocal bithermal caloric responses on conventional ENG. Although valuable, ENG caloric testing evaluates lateral semicircular canal function and should be considered a non-physiological test primarily of low frequency vestibular function. High frequency/acceleration head thrust testing clinically detected a "high frequency/acceleration vestibular loss" in 8/11(72.7%) cases.     

前庭自旋转试验和冷热试验在突发性聋预后评估中的应用比较

目的 在突发性聋患者诊治过程中运用前庭自旋转试验(vestibular autorotation test,VAT)和冷热试验(caloric test,CT)技术进行半规管功能检测,探讨两种方法在突发性耳聋预后评估中作用的差异性.方法 对23例突发性聋患者进行前庭功能检查(VAT,CT)及听力学检查(纯音测听、声导抗测试、听性脑干反应);用Stata 4.0统计软件做统计分析,分别按痊愈、显效、有效、无效,听力曲线类型及是否伴眩晕进行分组,用R×C联表对各计数因素行卡方检验.结果 统计结果表明两种方法差异无统计学意义(P>0.05).结论 前庭自旋转试验和冷热试验在突发性聋预后评估中的作用无差异.有无眩晕仅在前庭功能异常时对突聋的预后有较大的影响.突聋伴发的眩晕不一定是前庭损害的结果.