听神经病患者的前庭功能评估

Vestibular System Evaluation in Patients with Auditory Neuropathy

陈耔辰;张玉忠;徐勇;马伟军;成颖;张滟;王军利;陈彦飞;谷冬华;许珉;张青;

1:西安交通大学第二附属医院耳鼻咽喉头颈外科

2:西安一四一医院耳鼻喉科

3:西安交通大学口腔医院粘膜科

摘要
目的探讨听神经病(auditory neuropathy,AN)患者的前庭功能状况。方法检测10例(20耳)听神经病患者(听神经病组)的颈肌前庭诱发肌源性电位(cervical vestibular evoked myogenic potential,cVEMP)、眼肌前庭诱发肌源性电位(ocular vestibular evoked myogenic potential,oVEMP)及前庭双温试验(caloric test),并与年龄、性别相匹配的50例(100耳)正常人(对照组)比较,分析听神经病患者外周前庭功能。结果 AN组oVEMP的引出率为35.0%(7/20),cVEMP的引出率为25.0%(5/20),明显低于对照组[93.0%(93/100)和97.0%(97/100)](P<0.01)。AN组oVEMP振幅(3.05±1.47μV)低于对照组(7.04±4.31μV)(P<0.01),阈值(125.28±7.32dB SPL)高于对照组(119.17±4.93dB SPL)(P<0.05),P1潜伏期(15.94±0.67ms)、N1潜伏期(10.97±1.97ms)均较对照组(分别为14.71±1.26和10.27±0.73ms)延长(P<0.05);cVEMP振幅(101.15±14.39μV)较对照组(244.12±143.43μV)降低(P<0.01),N1-P1波间期(5.56±1.60ms)较对照组(7.25±1.59ms)缩短(P<0.05)。听神经病组中8例行双温试验,5例为单侧半规管功能减弱(CP>25%),异常率为62.50%(5/8)。除1例患者有轻微头晕,其他患者均无头晕、眩晕或行走不稳等前庭功能障碍表现。结论听神经病患者在听觉受损的同时常伴有潜在的前庭功能异常,主要表现为前庭诱发肌源性电位消失或阈值升高、振幅降低、潜伏期延长以及双温试验异常等。
关键词
听神经病;眼肌前庭诱发肌源性电位;颈肌前庭诱发肌源性电位;前庭功能
基金项目(Foundation):
国家自然科学基金项目(81541040,81670945);; 陕西省国际科技合作重点项目(2017KW-048);; 西安交通大学医学院第二附属医院人才培养专项基金[RC(GG)201407];; 西安交通大学第二附属医院新技术新疗法重点项目(2016YL-018)
作者
陈耔辰;张玉忠;徐勇;马伟军;成颖;张滟;王军利;陈彦飞;谷冬华;许珉;张青;
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