声诱发的短潜伏期负反应与前庭诱发的肌源性电位关系初步研究

The Relationship Between Acoustically Evoked Short Latency Negative Response and VEMP

吴子明;周娜;张素珍;刘兴健;杨伟炎;韩东一;

1:解放军总医院耳鼻咽喉-头颈外科解放军耳鼻咽喉科研究所

2:解放军总医院耳鼻咽喉-头颈外科解放军耳鼻咽喉科研究所

3:解放军总医院耳鼻咽喉-头颈外科解放军耳鼻咽喉科研究所

4:解放军总医院耳鼻咽喉-头颈外科解放军耳鼻咽喉科研究所

摘要
目的研究声诱发的短潜伏期负反应(acoustically evoked short latency negative response,ASNR)的特点,并初步证实该电位的前庭源性,即与前庭诱发的肌源性电位(vestibular evoked myogenic potentials,VEMP)同源。方法分别检测28例健康成人、16例前庭疾病和1例全聋患者的VEMP和ASNR,比较ASNR与VEMP之间的关系。结果ASNR正常引出率为87.5%,潜伏期正常值为3.50±0.25ms;2倍标准差作为正常值的上、下限,ASNR潜伏期的范围为34ms,阈值为804ms,阈值为8090dB nHL。16例前庭疾病患者均行双侧检查,在VEMP消失的9耳(9例)中,ASNR均未引出;VEMP低振幅的8例(8耳)中,5例(5耳)未引出ASNR,3例(3耳)ASNR正常引出。5例梅尼埃病患者接受甘油试验,1例(2耳)甘油试验前后VEMP与ASNR均正常,2例(4耳)双侧VEMP与ASNR甘油试验前异常,甘油试验后正常,1例(1耳)患侧VEMP正常,甘油试验前后无变化,ASNR由异常变为正常;1例(2耳)VEMP甘油试验前双侧异常,甘油试验后正常,但ASNR均未引出。1例听力正常的前庭神经炎患者,患侧VEMP未引出,ASNR电位也未引出。1例先天性全聋患者人工耳蜗植入前,VEMP、ASNR正常引出;植入后,术侧VEMP振幅降低,ASNR未引出。结论ASNR与VEMP可能均源于球囊。鉴于目前的结果,在不便进行VEMP检测时可用ASNR替代。
关键词
声诱发短潜伏期负反应电位;前庭诱发的肌源性电位;球囊
基金项目(Foundation):
作者
吴子明;周娜;张素珍;刘兴健;杨伟炎;韩东一;
参考文献

1 Kato T,Shiraishi K,Eura Y,et al.Aneural responses with3msla-tency evoked by loud sound in profoundly deaf patients[J].Audiol Neurootol,1998,3:253.

2 周娜,于黎明,刘传莲,等.重度聋的声诱发短潜伏期负反应[J].听力学及言语疾病杂志,2003,03:169.

3 Nong DX,Ura M,Kyuna A,et al.Saccular originof acousticallyevoked short latency negative response[J].Otol Neurotol,2002,23:953.

4 Ochi K,Ohashi T.Sound-evoked myogenic potentials and responses with3ms latency in auditory brain-stemresponses[J].Laryngo-scope,2001,111:1818.

5 Murofushi T,Iwasaki S,Takai Y,et al.Sound-evoked neurogenic responses with short latency of vestibular origin[J].Clinical Neuro-physiology,2005,116:401.

6. 周娜,吴子明,张素珍,等.不同刺激模式前庭诱发的肌源性电位的反应特性[J].中华耳鼻咽喉科杂志,2004,39:483.

7 Mc Cue MP,GuinanJr JJ.Sound-evoked activityin primary afferent neurons of a mammalian vestibular system[J].Am J Otolaryngol,1997,18:355.

8 Maurizi M,Paludetti G,Ottaviani F,et al.Auditory brain-stemre-sponses to middle-and low-frequency tone pips[J].Audiology,1984,23:75.

9 Takegoshi H,Murofushi T.Effect of white noise on vestibular evoked myogenic potentials[J].Hear Res,2003,176:59.

10 Bordure P,Desmadryl G,Uziel A,et al.Shortlatencyvestibular po-tentials evoked by electrical round windowstimulationin guinea-pig ear[J].Electroencephalogr Clin Neurophysiol,1989,73:464.

11 Murofushi T,Curthoys IS.Physiological and anatomical study of clicksensitive primary vestibular afferents inthe guinea pig[J].Acta Otolaryngol(Stockh),1997,117:66.

12 Isu N,Graf W,Sato H,et al.Sacculo-ocular reflexconnectivityin cats[J].Exp Brain Res,2000,131:262.

13 Sato H,Imagawa M,Isu N,et al.Properties of saccular nerveacti-vated vestibulospinal neurons in cats[J].Exp Brain Res,1997,116:381.

14 Cazals Y,Erre JP,Aurousseau C.Eighth nerve auditory evoked re-sponsesrecorded at the base of the vestibular nucleus in the guinea pig[J].Hear Res,1987,31:93.

15 Papathanasiou E,Zamba-Papanicolaou E,Pantziaris M,et al.Click evoked neurogenic vestibular potentials(NVESTEPs):a model of as-sessingthe function of the vestibular system[J].Electromyogr Clin Neurophysiol,2003,43:399.