突发性聋耳石器损伤情况及眼性前庭诱发肌源性电位与主观视觉垂直线相关性分析  

Otolith Damage Injury in Patients with Sudden Deafness and Correlation between oVEMPs and SVV

作　　者：莫誉华[1] 彭璐 侯涛[2] 黄展荣[2] 尹时华[2] MO Yuhua;PENG Lu;HOU Tao;HUANG Zhanrong;YIN Shihua(Department of Otolaryngology Head and Neck Surgery,Maternal and Children’s Health Hospital of the Guangxi Zhuang Autonomous Region,Nanning 530003,China;不详)

机构地区：[1]广西壮族自治区妇幼保健院耳鼻咽喉头颈外科 [2]广西医科大学第二附属医院耳鼻咽喉头颈外科

出　　处：《中华耳科学杂志》2024年第3期518-522,共5页Chinese Journal of Otology

基　　金：国家自然科学基金项目(82160613)。

摘　　要：目的 观察突发性聋患者耳石器损伤情况及其对预后的影响,探讨眼性前庭诱发肌源性电位(ocular vestibular evoked myogenic potential,oVEMP)与主观视觉垂直线(subjective visual vertical,SVV)的相关性。方法 选取2021年10月至2022年3月广西医科大学第二附属医院耳鼻咽喉头颈外科收治的单侧突发性聋患者66例,根据是否伴发眩晕,分为不伴眩晕组38例和伴眩晕组28例;根据耳石功能是否正常,分为耳石功能正常组37例和耳石功能异常组29例。选取同期30例无耳科疾病健康志愿者为对照组。治疗前后分别行纯音听阈、oVEMP、颈性前庭诱发肌源性电位(cervical vestibular evoked myogenic potential,cVEMP)及SVV检查,分析结果及oVEMP与SVV相关性。结果 伴眩晕组oVEMP、cVEMP、SVV异常率均高于不伴眩晕组、对照组,差异均有统计学意义(P<0.05);不伴眩晕组耳石器功能异常率均高于对照组,差异均有统计学意义(P<0.05)。突发性聋患者oVEMP与SVV无相关性,差异无统计学意义(P>0.05)。治疗后,不伴眩晕组总有效率高于伴眩晕组,差异有统计学意义(P<0.05);耳石器功能正常组总有效率高于耳石器功能异常组,差异均有统计学意义(P<0.05)。结论 突发性聋患者存在一定程度的耳石器功能损伤,突发性聋伴眩晕患者预后较不伴眩晕者差,耳石器功能对突发性聋患者的预后有一定的评估价值,oVEMP与SVV作为相对独立的两项耳石器功能检查,二者可相互补充,不能相互替代。Objective To report otolith damage in patients with sudden deafness and its influence on prognosis,as well as the correlation between ocular vestibular evoked myogenic potentials(oVEMPs) and subjective visual vertical(SVV).Methods Sixty-six patients with unilateral sudden deafness were selected as the study objects.Based on presence of vertigo,they were divided into a non-vertigo group(n=38) and a vertigo group(n=28).Based on otolith function,they were divided into a normal function group(n=37) and an abnormal function group(n=29).Thirty healthy volunteers served as the control group.Pure tone thresholds,oVEMPs,cervical vestibular evoked myogenic potentials(cVEMP) and SVV were obtained before and 2 weeks after treatment,and results and correlation between oVEMP and SVV were analyzed.Results The rates of abnormal oVEMPs,cVEMPs and SVV were higher than in the vertigo group than in the non-vertigo group and the control group(P<0.05),with no significant correlation between oVEMP and SVV(r=0.138,P>0.05).The rate of effective treatment for the non-vertigo group was 71.1%,compared to 46.4% for the vertigo group(c2=4.094,P<0.05);and 73.0% in the normal otolith function group,compared to 44.8% in the abnormal otolith function group(c2=5.394,P<0.05).Conclusion Some patients with sudden deafness can suffer from otolithogenic impairment,with worse prognosis in patients showing vertigo than those without.Otolith function tests have certain value in assessing prognosis in sudden deafness.oVEMP and SVV,as two relatively independent otolith function tests,can complement each other rather than replacing each other.

关 键 词：突发性聋 耳石器 前庭诱发肌源性电位 主观视觉垂直线 

分 类 号：R764.437[医药卫生—耳鼻咽喉科]