慢性中耳炎变温试验眼震电图结果的分析和校正  

Analysis and adjustment of the results of caloric test in chronic otitis media

作　　者：王璟[1] 迟放鲁[1] 卢华曾[1] 吴琍雯[1] 

机构地区：[1]复旦大学附属眼耳鼻喉科医院耳鼻喉科,上海200031

出　　处：《中国眼耳鼻喉科杂志》2010年第2期82-84,I0002,共4页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：上海市卫生局科研课题局级科研项目(2006Y09);"十一五"国家科技支撑计划(2007BAI18B14)

摘　　要：目的探讨视频眼震电图检查的变温试验在慢性中耳炎患者外周前庭功能诊断中的正确应用。方法统计分析60例慢性中耳炎患者的变温性眼震电图表现,并将患耳冷热气诱发的眼震方向和强度以及计算机内置公式(用眼震相对数值计算)和校正公式(用眼震绝对数值计算)计算出的半规管兴奋性不对称比和优势偏向比的结果进行对比。结果患耳或病变较重侧耳热气可诱发出正常方向眼震18例,反向眼震30例,未诱发出眼震12例;冷气可诱发出正常方向眼震57例,未诱发出眼震3例,无反向眼震者。患耳(有鼓膜穿孔)冷热气诱发眼震的强度差异有统计学意义(P<0.05),健耳冷热气诱发眼震的强度差异无统计学意义(P>0.05)。在热气诱发出患耳反向眼震的患者中,应用眼震的绝对数值计算半规管兴奋性不对称比,而只将方向带入优势偏向比的计算,会得出基本符合患者双耳眼震强度和方向性的结果。结论变温性眼震电图在慢性中耳炎前庭功能的诊断中需要根据患者病史、体征和检查数据进行综合分析,在有反向眼震出现时要对计算公式进行校正,才能得出正确的结论。Objective To investigate the application of caloric test in the examination of Videonystagmography （VNG） for the correct diagnosis of peripheral vestibular function of the patients with chronic otitis media. Methods Sixty patients with chronic otitis media were subjected to VNG and the results of caloric test were collected. According to the original formula（ calculating with the relative values） and the adjusted formula（ calculating with the absolute values）, the values of unilateral weakness （CP） and directional preponderance （DP） were calculated and compared. Results Eighteen patients were elicited nystagmus of normal direction by hot air in the unilateral ear with lesion or in the more se- rious ear with bilateral lesions, 30 patients with reversed directional nystagmus and 12 with no response. In cold air test, 57 patients showed normal results, 3 patients had no response, and no patients had reversed directional nystagmus. There was statically significance in nystagmus intension in affected-side ears by hot and cold air stimulus（P 〈0.05）, but not in the normal ears （P 〉 0.05 ）. In patients with reversed directional nystagmus elicited by hot air, it would get relatively cor- rect results in calculating CP and DP with adjusted formula comparing with the original ones. Conclusions In order to get correct results, the formula of CP and DP should be adjusted according to the detailed data, examinations as well as the values of caloric test in the diagnosis of vestibular function in patients with chronic otitis media. （ Chin J Ophthalmol and Otorhinolaryngol,2010,10：82-84）

关 键 词：视频眼震电图 变温试验 慢性中耳炎 眼震 前庭 

分 类 号：R764[医药卫生—耳鼻咽喉科]