骨导振动刺激诱发的前庭诱发肌源性电位

目的探讨B81骨振子在前庭诱发肌源性电位(vestibular evoked myogenic potentials, VEMPs)检测中的应用。方法对25例正常志愿者的双耳行插入式气导声刺激(air conducted sound, ACS)，单侧乳突B81骨导振动刺激(bone conducted vibration, BCV)的VEMPs检查，并对ACS ,BCV VEMPs检查结果进行统计学分析。结果ACS ,BCV 眼肌前庭诱发肌源性电位(ocular vestibular evoked myogenic potentials, oVEMP)的引出率分别为92%（46/50），98%（49/50）。BCV oVEMP与ACS oVEMP比较，两者引出率差异无统计学意义（P=0.36）;两者N1波潜伏期（P=0.00）、P1波潜伏期（P=0.00）、N1 P1波间期(P=0.01)及振幅(P=0.00)差异均具有统计学意义（P<0.05）;BCV oVEMP的N1、P1波潜伏期，N1 P1波间期均较短，而振幅较大。ACS ,BCV 颈肌前庭诱发肌源性电位(cervical vestibular evoked myogenic potential, cVEMP)的引出率均为100%（50/50）。BCV cVEMP与ACS cVEMP比较，N1波潜伏期差异无统计学意义（P=0.96），P1波潜伏期（P=0.02），P1 N1波间期(P=0.00)、振幅(P=0.04)均有统计学差异（P＜0.05）;BCV cVEMP的P1波潜伏期较短，P1 N1波间期较长，振幅较大。BCV oVEMP、ACS oVEMP、BCV cVEMP和ACS cVEMP的两耳间振幅不对称率（%）分别为：28.08±21.10、27.95±18.13、23.60±17.86、32.24±18.92。结论B81骨振子可以用于VEMPs的检测，骨导振动刺激在评价传导性听力损失患者的前庭耳石器功能时优于气导声刺激，可作为气导声刺激诱发VEMPs的补充检查。

Vestibular evoked myogenic potential induced by bone conducted vibration

ObjectiveTo investigate the application of B81 bone vibrator in the detection of vestibular evoked myogenic potentials (VEMPs). MethodsBilateral air conducted sound (ACS), unilateral B81 bone conducted vibration (BCV) VEMPs were detected in 25 normal volunteers. Their results were analyzed statistically.ResultsThe response rates of ACS , BCV ocular VEMP (oVEMP) were 92% (46/50) and 98% (49/50) respectively, and the difference was statistically insignificant (P>0.05). N1 wave latency, P1 wave latency and N1 P1 wave interval of BCV oVEMP were shorter than those of ACS oVEMP while the N1 P1 amplitude of BCV oVEMP was greater than that of ACS oVEMP, and the differences were all statistically different (all P<0.05). The response rates of ACS , BCV cervical VEMP(cVEMP) were both 100% (50/50). Compared with ACS cVEMP, BCV cVEMP had no statistical difference in N1 wave latency (P>0.05), while the P1 wave latency, P1 N1 wave interval and amplitude were statistically different (P<0.05). The P1 wave latency of BCV cVEMP was shorter, and the P1 N1 wave interval was longer and the amplitude was larger than those of ACS cVEMP respectively, and the differences were all statistically significant (all P<0.05). The amplitude asymmetry rates between the two ears of BCV oVEMP, ACS oVEMP, BCV cVEMP and ACS cVEMP were (28.08±21.10)%, (27.95±18.13) %, (23.60±17.86) %, and (32.24±18.92)%, respectively.ConclusionsB81 bone vibrator can be used for the detection of VEMPs. Bone conduced vibration is superior to air conducted sound in evaluating vestibular otolith function in patients with conductive hearing loss. It can be used as a supplementary examination of VEMPs.