梅尼埃病活动期cVEMP与oVEMP的频率调制特征  

Frequency Tuning Characteristics of Vestibular Evoked Myogenic Potentials during Meniere’s Disease Attacks

作　　者：柴滨[1] 杜一 陈姝嫤 任丽丽[2] 刘兴健[2] 吴子明[2] CHAI Bin;DU Yi;CHEN Shujin;REN Lili;LIU Xingjian;WU Ziming(Department of Neurodegenerative Disease,Center of Neurology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Vertigo Clinic,Department of Otolaryngology Head and Neck Surgery,Chinese PLA General Hospital,Beijing,100853;Department of Otolaryngology,Head and Neck Surgery,Rongchang District People's Hospital,Chongqing,402460)

机构地区：[1]首都医科大学附属北京天坛医院神经病学中心运动障碍性疾病科,北京100070 [2]解放军总医院耳鼻咽喉头颈外科学部眩晕诊疗中心,北京100853 [3]重庆市荣昌区人民医院耳鼻咽喉头颈外科,重庆402460

出　　处：《中华耳科学杂志》2022年第4期595-599,共5页Chinese Journal of Otology

摘　　要：目的 通过比较梅尼埃病(Meniere’s Disease,MD)活动期颈源性前庭诱发的肌源电位(VEMPs)1000Hz和500Hz振幅比值的频率调制特点,探究VEMPs频率调制特点在MD诊断中的价值。方法 选取2019年12月至2020年11月在解放军总医院眩晕诊疗中心进行就诊的55例单侧MD患者作为研究对象。所有患者均进行完整的问诊、纯音听力评估,以及前庭功能检查(双温检查、视频头脉冲(vHIT)与VEMP检查)。分别检查500Hz与1000Hz的短纯音的VEMP,计算1000Hz与500Hz VEMPs振幅比(Frequency amplitude ratio,IFAR)。结果 MD活动期患者不同侧别的IFAR:患侧cVEMP引出率低于对侧耳且有调制现象,而oVEMP对侧易产生调制,患侧与对侧调制发生率相似。cVEMP-IFAR(患侧)和前庭双温的异常率高于其他前庭功能检查。结论 数据表明单侧MD活动期患者的VEMP具有调制现象,该特征可在证明球囊内淋巴积水、观察MD进展或治疗阶段的积水变化以及临床分型方面有一定作用。Objective To report frequency tuning characteristics of vestibular evoked myogenic potentials(VEMPs) in patients with Meniere’s Disease(MD) attacks in the past two weeks by comparing 1000 Hz vs 500 Hz tone bursts induced VEMP amplitude ratios.Methods Fifty-five patients with unilateral MD who visited the vertigo center at the PLA General Hospital from December 2019 to November 2020 were included in the research.All patients underwent a complete interview,detailed audiological evaluation and vestibular function tests(caloric test,head impulse test,and VEMPs).The f Frequency amplitude ratio(IFAR) of VEMPs in response to 1000 Hz and 500 Hz tone burst stimulation was used to represent VEMP frequency tuning.Results The lesion side showed lower cVEMP detection rate with greater frequency tuning by IFAR as compared to the contralateral ear.oVEMP frequency tuning was more common on the contralateral side than on the lesion side.The incidence of detection of frequency tuning was similar for both the lesion and contralateral sides.Among vestibular function tests,abnormalities in the rate of cVEMP-IFAR on the lesion side and in caloric test were more common than others.Conclusion This study provides the evidence that VEMP frequency tuning exists during unilateral MD attacks,which may be useful in the identification of endolymphatic hydrops in the saccule,in monitoring hydrops during MD progression and in response to treatment,as well as in clinical classification of MD.

关 键 词：OVEMP cVEMP 梅尼埃病 调制 活动期 

分 类 号：R764[医药卫生—耳鼻咽喉科]