前庭功能对突发性聋患者预后的影响

Effect of Vestibular Function on the Prognosis of Sudden Deafness

赵竹;罗彬;管瑞锐;刘晓薇;孙敬武;钟雅琴;

1:安徽医科大学附属省立医院耳鼻咽喉头颈外科

摘要
目的探讨突发性聋患者前庭功能与预后的关系。方法对154例突聋患者(57例伴眩晕)治疗前和治疗后进行纯音听阈测试,其中86例(32例伴眩晕)进行了冷热水检查、前庭诱发肌源性电位检查(vestibular evoked myogenic potential,VEMP)以及视频头脉冲试验(video head impulse test,VHIT),运用单因素分析和多变量线性回归和logistic回归分析突聋患者伴或不伴眩晕、前庭功能检查是否异常等因素对听力预后的影响。结果伴眩晕的57例突聋患者听力恢复的几率是不伴眩晕者的0.426倍[OR值=0.426,95%置信区间(95%CI)为0.1990.914,P=0.028],恢复的程度低11.008dB(偏回归系数为11.008,95%CI为-17.3910.914,P=0.028],恢复的程度低11.008dB(偏回归系数为11.008,95%CI为-17.391-4.625,P=0.001);86例颈性前庭诱发肌源性电位(cervical vestibular evoked myogenic potential,cVEMP)检查的患者中结果异常的患者(30例)听力恢复的几率是正常患者的0.266倍(OR值=0.266,95%CI为0.093-4.625,P=0.001);86例颈性前庭诱发肌源性电位(cervical vestibular evoked myogenic potential,cVEMP)检查的患者中结果异常的患者(30例)听力恢复的几率是正常患者的0.266倍(OR值=0.266,95%CI为0.0930.763,P=0.014),恢复的程度低9.244dB(偏回归系数为9.244,95%置信区间为-16.6090.763,P=0.014),恢复的程度低9.244dB(偏回归系数为9.244,95%置信区间为-16.609-1.879,P=0.015);VHIT检查中水平半规管检查结果异常的患者(30例)听力恢复的几率是正常者的0.262倍(OR值=0.262,95%CI为0.095-1.879,P=0.015);VHIT检查中水平半规管检查结果异常的患者(30例)听力恢复的几率是正常者的0.262倍(OR值=0.262,95%CI为0.0950.724,P=0.010),恢复的程度低10.283dB(偏回归系数为10.283,95%CI为-17.3970.724,P=0.010),恢复的程度低10.283dB(偏回归系数为10.283,95%CI为-17.397-3.169,P=0.005);VHIT检查中前半规管检查结果异常的患者(17例)听力恢复的几率是正常者的0.349倍(OR值=0.349,95%CI为0.125-3.169,P=0.005);VHIT检查中前半规管检查结果异常的患者(17例)听力恢复的几率是正常者的0.349倍(OR值=0.349,95%CI为0.1250.974,P=0.044);眼性前庭诱发肌源性电位(ocular vestibular evoked myogenic potential,oVEMP)检查结果异常的患者(30例)比结果正常患者恢复程度低8.408dB(偏回归系数为8.408,95%CI为-16.0650.974,P=0.044);眼性前庭诱发肌源性电位(ocular vestibular evoked myogenic potential,oVEMP)检查结果异常的患者(30例)比结果正常患者恢复程度低8.408dB(偏回归系数为8.408,95%CI为-16.065-0.750,P=0.032)。结论前庭系统损伤是听力预后差的高危因素,突聋伴发眩晕的患者前庭功能损伤的几率更高,且损伤的程度更重,前庭功能检查应作为突聋患者的常规检查。
关键词
突聋;前庭功能;前庭诱发肌源性电位;冷热试验;视频头脉冲试验
基金项目(Foundation):
国家自然科学基金面上项目(81470699)
作者
赵竹;罗彬;管瑞锐;刘晓薇;孙敬武;钟雅琴;
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