不伴眩晕的突发性感音神经性耳聋患者隐匿的前庭机能障碍研究  

Vestibular Dysfunctionin Patients with Sudden Sensorineural Hearing Loss without Vertigo

作　　者：牛晓蓉[1,2] 张青[1,2] 韩鹏[1,2] 吴彩芹[1,2] 杜小滢[1,2] 李静静[1,2] 杨慧[1,2] 井晓红[1,2] 许珉[1,2] 

机构地区：[1]西安交通大学医学院第二附属医院耳鼻咽喉头颈外科,西安710004 [2]西安交通大学医学院第二附属医院耳病研究所,西安710004

出　　处：《四川大学学报（医学版）》2015年第3期426-430,共5页Journal of Sichuan University(Medical Sciences)

基　　金：国家自然科学基金(No.30973300);中央高校基本科研业务费专项资金(No.2012jdhz13);陕西省国际科技合作重点项目(No.2013KW-28);西安市科技攻关项目(No.SF13151);西安交通大学医学院第二附属医院人才培养专项基金〔No.RC(GG)201407〕资助

摘　　要：目的观察不伴眩晕的突发性感音神经性耳聋(简称突聋)患者前庭机能及损伤范围。方法选择不伴眩晕的单侧突聋患者42例(42耳),分别进行眼肌和颈肌前庭诱发肌源性电位(oVEMP,cVEMP)及Caloric试验;以伴眩晕的单侧突聋患者62例(62耳)及年龄和性别匹配的健康人25例(50耳)为对照,分析不伴眩晕的突聋患耳的前庭机能受损状况。结果突聋不伴眩晕组患耳oVEMP、cVEMP的异常率为54.8%、52.4%,Caloric试验异常率52.4%;伴眩晕组患耳oVEMP、cVEMP异常率为64.5%、48.4%,Caloric试验异常率75.9%;正常对照组oVEMP、cVEMP异常率为26.0%、14.0%。突聋不伴眩晕组患耳较正常耳oVEMP和cVEMP异常率高(P<0.01);突聋不伴眩晕及伴眩晕组患耳oVEMP、cVEMP及Caloric试验异常率相当(P>0.05)。结论不伴眩晕的突聋患耳可以伴有前庭机能受损,且受损几率与伴眩晕突聋患耳相当,是否伴有眩晕可能与前庭机能损害的程度和范围无关。Objective To observe the vestibular dysfunction in sudden sensorineural hearing loss（SSHL）patients without vertigo.Methods Forty-two cases of unilateral SSHL without vertigo were enrolled in the study from May 2012 to May 2014.All patients underwent air conducted sound elicited oVEMP and cVEMP respectively.Some of them also received caloric test.Sixty-two SSHL patients with vertigo and twenty-five age-and gendermatched normal subjects were recruited as controls to analyze the vestibular dysfunction in SSHL patients without vertigo.Results Abnormal oVEMP was observed in 54.8% affected ears without vertigo（23/42）,64.5% ears with vertigo（40/62）,and 26.0% normal ears（13/50）.Abnormal cVEMP was observed in 52.4% affected ears without vertigo（22/42）,48.4% ears with vertigo（30/62）,and 14.0% normal ears（7/50）.Caloric test was operated in 21 SSHL patients without vertigo and 29 patients with vertigo.Abnormal caloric test was observed in52.4%（11/21）SSHL patients without vertigo and 75.9%（22/29）SSHL patients with vertigo respectively.Statistical significance was found in oVEMP and cVEMP rates between SSHL without vertigo and normal group（P〈0.01）.However,no significant statistical difference was found in oVEMP,cVEMP rates and caloric test between SSHL without vertigo and SSHL with vertigo group（P〉0.05）.Conclusion Vestibular function could be damaged in SSHL patients without vertigo.The abnormal rates of oVEMP,cVEMP and caloric test in SSHL patients without vertigo were similar to that of SSHL patients with vertigo.The appearance of vertigo might be irrelevant to the range and extent of vestibular dysfunction.

关 键 词：突聋 眩晕 前庭诱发肌源性电位 Caloric试验 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]