伴眩晕的突发性聋患者椭圆囊-球囊功能分析

目的通过观察突聋伴眩晕患者主观垂直视觉(subjective visual vertical,SVV)偏斜和前庭诱发肌源性电位(vestibular evoked myogenic potentials,VEMP),了解椭圆囊-球囊功能与症状的关系。方法16例突聋伴眩晕的患者和10例突聋无眩晕的患者分别行SVV及VEMP检查。其中,6例突聋伴眩晕患者行前庭双温试验检查。结果伴晕眩的突聋患者中,VEMP异常者8例,正常8例;SVV异常6例,正常10例,且所有SVV异常者,VEMP均异常。不同程度听力损失之间VEMP正常与异常率无显著性差异(P>0.05),纯音听阈与SVV的关系在统计学上也无相关性(P>0.05)。结论突聋伴眩晕患者可伴有球囊和/或椭圆囊功能障碍,前庭上神经和前庭下神经损伤无特定的规律。全面的前庭功能评价有助于进一步了解伴眩晕的突聋患者的前庭功能状态。

Analysis of Saccule and Utricle Function in Sudden Deafness with Vertigo

Objective To investigate the subjective visual vertical(SVV) and vestibular evoked myogenic potentials(VEMP) in patients suffering from sudden deafness with vertigo and the role of otolith in the development of this symptom.Methods 16 patients had sudden deafness with vertigo and 10 patients without vertigo were examined with the test of SVV and VEMP. All of the patients were tested with pure tone hearing threshold and six patients with vertigo were tested with bithermal caloric test.Results Among 16 patients with sudden deafness with vertigo, eight patients had abnormal VEMP and the other 8 patients were normal; six had abnormal SVV and 10 had normal SVV. Whereas 10 patients only with sudden deafness had normal VEMP and SVV. The patients were grouped according to average hearing level of 0.5, 1, 2,4 kHz. The results indicated that normal or abnormal VEMP and SVV were not associated with hearing level.The branches of superior vestibular nerve could be damaged simultaneously or separately.Conclusion Sudden deafness with vertigo may involve the damage of saccule and or utricle. And there is no specific rule of the damage pattern. Comprehensive evaluation of vestibular function is needed to understand the status of vestibular system function after sudden deafness with vertigo.