前庭神经炎眼倾斜反应临床分析  

Analysis of features of ocular tilt reaction for patients with vestibular neuritis

作　　者：王涛[1] 瞿申红[1] 袁弘[1] 叶林松[1] 崔凌[2] WANG Tao;QU Shenhong;YUAN Hong;YE Linsong;CUI Ling(Department of Otorhinolaryngology Head and Neck Surgery,Guangxi Zhuang Autonomous Region People＇s Hospital,Nanning,530021,China;Department of Ophthalmology,Guangxi Zhuang Autonomous Region People＇s Hospital)

机构地区：[1]广西壮族自治区人民医院耳鼻咽喉头颈外科,南宁530021 [2]广西壮族自治区人民医院眼科

出　　处：《临床耳鼻咽喉头颈外科杂志》2018年第14期1091-1094,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:分析前庭神经炎患者眼倾斜反应临床的特点,探讨其对前庭神经炎诊断的价值。方法:随机选取2016-01-2018-03期间该院确诊的35例前庭神经炎患者均进行床旁前庭功能查体,包括眼震、头脉冲试验(HIT)、摇头试验(HSN)、眼倾斜反应(OTR),Romberg征,Fukuda原地踏步。均行头颅CT平扫及脑MRI平扫+DWI排除脑出血或梗死。纯音测听及声导抗检查了解听力情况及中耳压力情况。结果:35例前庭神经炎患者中,29例(82.8%)可见眼倾斜反应,其中典型眼倾斜反应5例(14.3%),非典型眼倾斜反应24例(68.5%),非典型眼倾斜反应分为两类:(1)仅有静态眼旋转4例(11.4%),(2)仅有眼偏斜及头倾斜20例(57.1%)。29例患者眼倾斜反应消失时间1~4d,平均(2.62±0.26)d。结论:眼倾斜反应作为诊断前庭神经炎的一个重要指标,常常被临床医师所忽视,其阳性率高,可以作为床旁前庭功能重点检查项目。Objective：To analyze the clinical characteristics of ocular tilt reaction in vestibular neuritis patients and discuss its value to the diagnosis of vestibular neuritis.Method：Thirty-five patients with vestibular neuritis confirmed between January 2016 and March 2018 underwent bedside vestibular function physical examination including nystagmus,head impulse test（HIT）,head shaking nystagmus（HSN）,ocular tilt reaction（OTR）,Romberg sign,Fukuda stepping.All patients underwent head CT scan and brain MRI scan＋ DWI to exclude bleeding and infarction.Pure tone audiometry and acoustic impedance check to understand the hearing and middle ear pressure.Result：In all the 35 patients with vestibular neuritis,OTR was observed in 29 patients（82.8%）;Typical OTR was seen in 5 of 35 patients（14.3%）,atypical OTR was seen in 24 of 35 patients（68.5%）,static ocular torsion were observed in 4 of 35 patients（11.4%）.Ipsiversive skew deviation and head tilt were observed in 20 of35 patients（57.1%）.In 29 cases,the symptoms of patients with OTR disappeared after 1-4 days,with an average of（2.62 ± 0.26）days.Conclusion：As an important index for diagnosis of vestibular neuritis,OTR is often neglected by clinicians,and its positive rate is high,which can be used as a key inspection items of bedside vestibular function physical examination.

关 键 词：前庭神经炎 眼倾斜反应 

分 类 号：R764[医药卫生—耳鼻咽喉科]