迟发性膜迷路积水的诊断

目的：探讨迟发性膜迷路积水（DEH）的诊断手段及意义。方法：15例DEH患者，分别行纯音听阈及耳蜗电图检查、前庭双温试验和前庭诱发的肌源性电位检查（VEMP），用以诊断及判断DEH的侧别和病变累及范围。结果：15例患者均为中～重度以上感音神经性聋。积水与听力下降同侧10例，对侧4例，双侧1例。水平半规管和球囊均有积水5例，水平半规管积水6例，球囊积水2例。VEMP异常者7例，其中1例患侧p13-n23振幅消失，2例p13潜伏期延长，4例患侧p13-n23低振幅。结论：DEH的诊断除了纯音测听外，耳蜗电图检查、前庭双温试验和VEMP检查是重要的实验室检查，应列为诊断常规。

Diagnosis of delayed endolymphatic hydrops

Objective:To investigate the diagnostic methods and significance of several tests for delayed endolymphatic hydrops(DEH).Method:Fifteen patients with delayed endolymphatic hydrops were tested with pure tone threshold, ECochG,bithermal caloric test and vestibular evoked myogenic potentials test to detect the lesioned side and the extent of hydrops.Result:All of the 15 patients had sensorineural hearing loss to the medium-severe extent at least.Ten were the ipsilateral type, four contralateral type and one bilateral type. Five cases had abnormal horizontal semicircular canal (HSCC) hydrops and saccular hydrops; six cases had abnormal HSCC function and nomal saccular function; two cases had abnormal saccular function and normal HSCC function. The seven abnomal VEMP took the forms of loss of p13-n23, elongation of the latency of p13 or depressed amplitude cases with of p13-n23.Conclusion:ECochG, bithermal caloric test and VEMP may play a major role in the diagnosis of delayed endolymphatic hydrops and they should be utilized as the routine tests.