突发性聋患者气导短纯音诱发的眼肌前庭诱发肌源性电位  

Air-conducted ocular vestibular-evoked myogenic potential in patients with sudden sensorineural hearing loss

作　　者：王佩杰[1,2] 罗伟[1,2] 吴麟 陈震宇 陆小燕 

机构地区：[1]安徽医科大学解放军八一临床学院,南京210002 [2]解放军第八一医院耳鼻咽喉头颈外科

出　　处：《临床耳鼻咽喉头颈外科杂志》2015年第14期1243-1247,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：南京军区十二五科研基金课题MS057资助(No:2011FZ0035)

摘　　要：目的：研究突发性聋患者的眼肌前庭诱发肌源性电位（oVEMP）,了解突发性聋患者前庭系统受损范围及程度。方法：选择2013-12-2014-12期间35例诊断为单侧突发性聋的患者。进行气导短纯音诱发的oVEMP检测,计算P1和N1的潜伏期,P1~N1波间期及P1~N1复合波振幅,分别以单侧突发性聋患者的相对健康耳及55例（110耳）健康人对照,分析突发性聋患者椭圆囊及前庭上神经的功能。结果：35例突发性聋患者中,31例双耳均引出oVEMP图形,4例患耳未引出oVEMP图形,患耳引出率88%,95dBHL气导短纯音刺激下31患耳获得P1的潜伏期（12.16±0.76）ms;N1的潜伏期（16.94±2.57）ms,P1~N1波间期（5.16±0.73）ms,P1~N1复合波振幅（2.89±1.66）μv。95dBHL气导短纯音刺激下35健耳获得P1的潜伏期（11.92±0.85）ms;N1的潜伏期（17.07±1.04）ms,P1~N1波间期（5.15±0.69）ms,P1~N1复合波振幅（5.44±2.53）μv;55例健康人均引出典型的oVEMP波形,95dBHL气导短纯音刺激下获得P1的潜伏期（11.53±0.80）ms;N1的潜伏期（16.61±0.87）ms,P1~N1波间期（5.18±1.04）ms,P1~N1复合波振幅（5.96±2.59）μv。突发性聋组患耳、对侧健耳、健康对照组分别进行比较,P1和N1的潜伏期,P1~N1波间期在各组间差异无统计学意义（P〉0.05）。P1~N1复合波振幅突发性聋组患耳明显低于对侧健耳及健康人,差异有统计学意义（P〈0.05）。结论：通过oVEMP检测突发性聋患者,可观察到P1~N1复合波振幅降低,可能与椭圆囊及前庭上神经的损害有关。Objective：To investigate the characteristics of air-conducted ocular vestibular-evoked myogenic potential（oVEMP）in patients with sudden sensorineural hearing loss（SSHL）.So as to understanding the range and the degree of the vestibular system damage in patients with SSHL.Method：Thirty-five cases of unilateral SSHL were enrolled as the observing group from December in 2013 to December in 2014.500 Hz air-conducted tone burst was employed as stimulation.Fifity-five healthy young subjects were recruited as the control group.The results were compared between the affected ears,the contralateral ears and the normal controls.Result：Thirty-five patients with SSHL,31 of them in both ears lead to oVEMP Waveform,4sick ears did not elicit oVEMP waveform,extraction rate of 88%.95 dBHL air-conducted get the latencies of P1 and N1,P1-N1 interval,peak-to-peak P1-N1 amplitude in healthy ear were（11.92±0.85）ms;（17.07±1.04）ms,（5.15±0.69）ms,（5.44±2.53）μv.95 dBHL air-conducted get the latencies of P1 and N1,P1-N1 interval,peak-to-peak P1-N1 amplitude in sick ear were（12.16±0.76）ms;（16.94±2.57）ms,（5.16±0.73）ms,（2.89±1.66）μv.The 55cases（110ears）were elicited P1-N1 complex typical,extraction rate was 100%.The threshold of oVEMP examination was（82.23±2.92）dBHL,95 dBHL air-conducted get the latencies of P1 and N1,P1-N1 interval,peak-to-peak P1-N1 amplitude in these healthy young people were（11.53±0.80）ms,（16.61±0.87）ms,（5.18±1.04）ms,（5.96±2.59）μv,there were no significant differences between the affected ears,the contralateral ears and the normal controls in the latencies P1 and N1,P1-N1 interval.The wave amplitude in SSHL were lower than the healthy ear and the healthy control group.Conclusion：Through the detection of oVEMP in patients with SSHL,we observed that P1-N1 wave amplitude decreased,and it may be related to the damage of the utricle and vestibular nerve.

关 键 词：眼肌前庭诱发肌源性电位 椭圆囊 球囊 突发性聋 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]