突发性聋与前庭神经炎的前庭损伤差异性研究

目的　通过比较研究伴有前庭损伤的突发性聋和前庭神经炎，探讨两类疾病前庭损伤的差异。方法  2016-02-25～2016-07-20解放军总医院耳鼻咽喉头颈外科眩晕诊疗中心，突发性聋组55例，其中39例伴眩晕患者；前庭神经炎组46例。前庭双温冷热试验、头脉冲试验、颈性前庭诱发肌源性电位、眼性前庭诱发肌源性电位评价及比较突发性聋及前庭神经炎两组疾病前庭损伤差异性。结果　前庭双温冷热试验突发性聋组异常率25.45%，前庭神经炎组异常率97.82%，两组比较差异有统计学意义（χ2=54.01，P＜0.001）。头脉冲试验：突发性聋组异常率9.09%，前庭神经炎组异常率32.61%，两组比较差异有统计学意义（χ2=8.72，P =0.003）。颈性前庭诱发肌源性电位突发性聋组异常率69.10%，前庭神经炎组异常率43.47%，两组比较差异有统计学意义（χ2=6.72，P =0.010）；眼性前庭诱发肌源性电位突发性聋组异常率54.55%，前庭神经炎组异常率63.04%，两组比较差异无统计学意义（χ2=0.745，P =0.388）。结论　突发性聋与前庭神经炎两组患者前庭损伤比较，突发性聋合并眩晕者更有可能为球囊/前庭下神经受累，损伤部位更多靠近神经终末端，损伤是低频段的；前庭神经炎的前庭损伤范围大，损伤是全频段的，高位可能性更大。

Study on difference of vestibular damage of sudden deafness and vestibular neuritis

OBJECTIVE To explore the difference of vestibular damage between sudden deafness and vestibular neuritis.METHODS Patients in otolaryngology head and neck surgery eenterin PLA general hospital from February 25 in 2016 to July 20 in 2016 were included in this research.Among these patients,55 cases were diagnosed as sudden deafness group,including 39 cases With vertigo.And other 46 cases were diagnosed as vestibular neuritis.Vestibular bithermal caloric test,head impulse test(head impulse test,HIT),cervical vestibular evoked myogenic potentials(cervical vestibular evoked myogenic potential,cVEMP),ocular vestibular evoked myogenic potentials(ocular vestibular evoked myogenic potential,oVEMP) were performed to evaluate their vestibular function and were compared.RESULTS The abnormal rate of vestibular bithermal caloric test in sudden deafness group 25.45％,and 97.82％ in vestibular neuritis group.There was significant difference between two groups(x2=54.01,P＜0.001).HIT:the abnormal ratein sudden deafness groupwas 9.09％ and 32.61％ in vestibular neuritis group,there was significant difference between two groups(x2=8.72,P=0.003).VEMP:the abnormal rate of cVEMP in sudden deafness group was 69.10％ and 43.47％ in vestibular neuritis group,there was significant difference between two groups(x2=6.72,P=0.010).But the abnormal rate of oVEMP in sudden deafness group was 54.55％ and 63.04％ in vestibular neuritis group,and there was not statistically significant difference between two groups(x2=0.745,P=0.388).CONCLUSION The vestibular damage of sudden deafness with vertigo was more likely involved with saccule and inferior vestibular nerve,more close to the nerve terminal,and the injury was in a low frequency range;but the vestibular damage in vestibular neuritis was wider,and the injury involved a full band,the damaged part may be higher.