不同刺激声骨导眼肌前庭诱发肌源性电位特征分析

Characteristics of Vestibular Myogenic Evoked Potentials in Vocal Bones Stimulated by Different Frequencies

王敏姣;林颖;刘嘉伟;樊小勤;钟波;查定军;

1:空军军医大学第一附属医院耳鼻咽喉头颈外科听力中心

2:中国计量科学研究院声学室

摘要
目的分析不同刺激声骨导诱发的眼肌前庭诱发肌源性电位(bone conducted ocular vestibular evoked myogenic potential,BC-oVEMP)特征,分析其反应阈、潜伏期和振幅,探讨其最佳刺激声,并获得正常值范围,为临床诊断前庭疾病提供参考。方法分别用500、1 000、2 000Hz短纯音及短声对20例(40耳)正常青年人进行BC-oVEMP测试,刺激声起始强度为仪器每个频率可输出的最大峰值等效力级(force level,FL),以5dB FL为步阶测试至阈值,分别记录其n1-p1潜伏期、振幅、波间期,得出其对称性和振幅比。结果在最大输出强度下,500、1 000、2 000 Hz短纯音及短声四种刺激声诱发的BC-oVEMP n1-p1引出率分别为100.0%、85.0%、42.50%及52.50%;反应阈分别为127.63±4.76、130.89±3.06、114.94±2.54、117.25±3.98dB FL;n1波潜伏期分别为10.14±0.62、11.80±1.66、13.61±0.81、12.52±0.82ms;p1波潜伏期分别为15.65±1.09、16.08±1.61、17.59±0.98、16.32±0.54ms;n1-p1振幅分别为12.14±5.85、2.80±1.82、2.69±1.14、2.85±1.78μV。结论500、1 000、2 000Hz短纯音及短声四种骨导刺激声均可诱发出眼肌前庭诱发肌源性电位;在最大输出强度下500Hz短纯音BC-oVEMP引出率和振幅最高,为最佳刺激声,便于椭圆囊及其传导通路的相关疾病诊断。
关键词
骨导眼肌前庭诱发性肌源电位;短纯音;短声
基金项目(Foundation):
国家自然科学基金面上项目(81670924,81470695)
作者
王敏姣;林颖;刘嘉伟;樊小勤;钟波;查定军;
参考文献

1郭良蓉,李祖飞,田永胜.骨导前庭诱发肌源性电位的应用进展[J].中国听力语言康复科学杂志,2017,15:434.

2 Sheykhols K,Murofushi T,Kermany MH.Bone-conducted evoked myogenicpotentials from the strnocleidomastoid muscle[J].Acta Otolaryngol,2000,120:731.

3刘嘉伟,樊小勤,林颖.正常青年人骨导眼肌前庭肌源诱发电位特征初步研究[J].中国听力语言康复科学杂志,2017,15:356.

4胡娟,许珉,张青.眼肌前庭诱发肌源性电位的研究现状及展望[J].临床耳鼻咽喉头颈外科杂志,2013,27:388.

5 Halmagyi GM,Yavor RA,Colebatch JG.Tapping the head activates the vestibular system:a new use for the clinical reflex hammer[J].Neurology,1995,45:1927.

6 Welgampola MS,Rosengren SM,Halmagyi GM.Vestibular activation by bone conducted sound[J].J Neurol Neurosurg Psychiatry,2003,74:771.

7 Curthoys IS,Vulovic V,Burgess AM.Neural basis of new clinical vestibular tests:otolithic neural responses to sound and vibration[J].Clinical and Experimental Pharmacology and Physiology,2014,41:371.

8 Curthoys IS,Kim J,McPhedran SK.Bone conducted vibration selectively activates irregular primary otolithic vestibular neurons in the guinea pig[J].Experimental Brain Research,2006,175:256.

9 Todd NP,Rosengren SM,Colebatch JG.Tuning and sensitivity of thehuman vestibular system to low-frequency vibration[J].Neurosci Lett,2008,444:36.

10 Yasuhiro C,Shinichi I,Chisato F.Frequency tuning properties of ocular vestibular evoked myogenic potentials[J].Auditory and Vestibular Systems,2009,20:1491.

11杨引通,许珉,张青.不同种类刺激声对国人正常青年人群眼肌前庭诱发肌源性电位的影响[J].临床耳鼻咽喉头颈外科杂志,2014,28:948.

12张青,宋辉,胡娟.气导短纯音诱发的眼肌前庭诱发肌源性电位在健康青年人群中的波形特征[J].中华耳鼻咽喉头颈外科杂志,2012:47:15.

13 Curthoys IS.A critical review of the neurophysiological evidence underlying clinical vestibular testing using sound,vibration and galvanic stimuli[J].Clinical Neurophysiology,2010,121:132.

14王佩杰,罗伟,陆小燕.健康青年人气导短纯音诱发的眼肌前庭诱发肌源性电位[J].临床耳鼻咽喉头颈外科杂志,2014,28:1495.