眼性前庭诱发肌源电位对迷路积水定位诊断的价值探讨
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摘要
目的探讨膜迷路积水患者眼肌前庭诱发肌源性电位(oVEMP)的临床特征。方法对40例膜迷路积水患者患者及38例(76耳)年龄、性别与之匹配的健康人进行眼肌前庭诱发肌源性电位(oVEMP)测试,分析对比oVEMPs的引出率及各参数指标。结果 (1)病例组患耳和健耳的oVEMP引出率和振幅均低于对照组;(2)病例组患耳和健耳的oVEMP与对照组oVEMP引出率、峰-峰波幅差异有显著性意义;(3)病例组与对照组振幅比、不对称性比较差异具有著性意义结论 oVEMP可以作为迷路积水异常变化的客观量化评估指标,并迷路积水的确诊提供一定帮助。
Objectives To evaluate changes of ocular vestibular evoked myogenic potentials(oVEMPs) in a large group(n = 40) of patients with endolymphatic hydrops. Methods Forty patients with endolymphatic hydrops patients and 38 age andgender matched normal subjects(control group) were included in the study. Both patients and normal subjects underwent con-ventional oVEMP test. Results from the affected ear, the contralateral ear in patients and ears in control subjects were com-pared. Results In patients with endolymphatic hydrops, response rates were lower and oVEMP amplitudes were smaller than innormal subjects. The differences were statistically significant. Conclusion oVEMP can be a relevant addition to the currentdiagnostic workup in patients with possible endolymphatic hydrops.
Objectives To evaluate changes of ocular vestibular evoked myogenic potentials(oVEMPs) in a large group(n = 40) of patients with endolymphatic hydrops. Methods Forty patients with endolymphatic hydrops patients and 38 age andgender matched normal subjects(control group) were included in the study. Both patients and normal subjects underwent con-ventional oVEMP test. Results from the affected ear, the contralateral ear in patients and ears in control subjects were com-pared. Results In patients with endolymphatic hydrops, response rates were lower and oVEMP amplitudes were smaller than innormal subjects. The differences were statistically significant. Conclusion oVEMP can be a relevant addition to the currentdiagnostic workup in patients with possible endolymphatic hydrops.
引文
1 COLEBATCH JG,HALMAGYI GM,SKUSE NF.Myogenic potentials generated by a click-evoked vestibulacollic reflex.J Neurol Neurosurg Psychiatry,1994;57:190-197.
2 ROSRNGR EN SM,MCANGUS TNP,COLEBATCH JG Vestibularevoked extraocular potentials produced by stimulation with boneconducted sound.Clin Neurophysiol,2005;116:1938-1948.
3 DERIU F,ORTU E,CAPOBIANCO S,et al.Origin of sound-evoked EMG responses in human masseter muscles.J Physiol,2007;580:195-209.
4 Fang Z.M.,C.X.,Gu X.,et al.A new magnetic resonance imaging scoring system for perilymphatic space appearance after intratympanicgadolinium injection,and its clinical application.Laryngol Otol,2012;126(5):454-459.
5 Xi Chen,Xiao-Dong Zhang,Xi Gu,et al.Endolymphatic Space Imaging in Idiopathic Sudden Sensorineural Hearing Loss With Vertigo.Laryngoscope,2012;122(10):2265-8.
6 XGU,Z-M FANG,X CHEN,et al.Diagnostic value of three-dimensional magnetic resonance imaging of inner ear after intratympanic gadolinium injection,and clinical application of magnetic resonance imaging scoring system in patients with delayed endolymphatic hydrops.The Journal of Laryngology&Otology,2014,128(1):53-59.
7 李婧,杨旭,吴子明.眼源性前庭诱发肌源性电位.中华耳科学杂,2014,12(2):231-234.
8 Nakashima T,Naganawa S,Pyykko I,etal.Grading of endolymphatic hydrops using magnetic resonance imaging.Acta Oto Laryngologica,2009;129:5-8.
9 Rosengren SM,Mc Angus Todd NP,Colebatch JG.Vestibular evoked extraocular potentials produced by stimulation with bone-conducted sound.Clinical Neurophysiology,2005;116(8):1938-1948.
10 Murofushi T,Nakahra H,Yoshimura E,et al.Association of air-conducted sound o VEMP findings with c VEMP and caloric test findings in patients with unilateral peripheral vestibular disorders.Acta Laryngology,2011;131(9):945-950.
11 Iwasaki S,Smulders YE,Burgess AM,et al.Ocular vestibular evoked myogenic potentials to bone conducted vibration of the midline forehead at Fz in healthy subjects.Clin Neurophysiol,2008;119(9):2135-2147.
12 Chihara Y,Iwasaki S,Ushio M,et al.Vestibular-evoked extraocular potentials by air-conducted sound:Another clinical test for vestibular function.Clinical Neurophysiology,2007;118(12):2745-2751.
13 Chihara Y,Iwasaki S,Ushio M,et al.Ocular vestibular-evoked myogenic potentials(o VEMPs)require extraocular muscles but not facial or cochlear nerve activity.Clin Neurophysiol,2009;120(3):581-587.
14 Amikulec A,Kowalczyk KA,Pfitzinger ME,et al.Negative association between treated osteoporosis and benign paroxysmal positional vertigo in women.J Laryngol Otol,2010;124(4):374-376.
15 Rosengren SM,Mc Angus Todd NP,Colebatch JG.Vestibular evoked extraocular potentials produced by stimulation with bone-conducted sound.Clinical Neurophysiology,2005;116(8):1938-1948.
16 Schuknecht HF,Gulya AJ.Endolymphatic hydrops.An overview and classification.Ann Otol Rhinol Laryngol Suppl,1983;106:1-20.
17 吴子明,张素珍,杨伟炎,等.膜迷路积水的实验室检查.临床耳鼻喉头颈外科杂志,2007,21(7):333-336.
18 Taylor RL,Wijewardene AA,Gibson WPR,et al.The vestibular evokedpotential profile of Meniere’s disease.Clin Neurophysiol,2011;12:1256-1263.
19 Winters SM,Campschroer T,Grolman W,Klis SFL.Ocular vestibular evoked myogenic potentials in response to air-conducted sound in Meniere’s disease.Otol Neurotol,2011;32:1273-1280.
20 郭维维,张素珍,李兴启.瞬态耳声发射主频对梅尼埃病的诊断价值.听力学及言语疾病杂志,1998,6(4):174-176.
21 Wang SJ,Weng WJ,Jaw FS,Young YH.Ocular and vestibular evoked myogenic potentials:a study to determine whether air-or bone-conducted stimuli are optimal.Ear Hear,2010;31:283-288.
22 Akkuzu G,Akkuzu B,Ozluoglu LN.Vestibular evoked myogenic potentials in benign paroxysmal positional vertigo and Meniere’s disease.Eur Arch Otorhinolaryngol,2006;263:510-517.
23 Young YH,Huang TW,Cheng PW.Assessing the stage of Meniere’s disease using vestibular evoked myogenic potentials.Arch Otolaryngol Head Neck Surg,2003;129:815-818.
24 Rauch SD,Zhou G,Kujawa SG,Guinan JJ,Herrmann BS.Vestibular evoked myogenic potentials show altered tuning in patients with Meniere’s disease.Otol Neurotol,2004;25:333-338.
25 Lin MY,Timmer FC,Oriel BS,et al.Vestibular evoked myogenic potentials(VEMP)can detect asymptomatic saccular hydrops.Laryngoscope,2006;116:987-992.
26 Huppert D,Strupp M,Brandt T.Long-term course of Meniere’s disease revisited.Acta Otolaryngol,2010;130:644-651.
2 ROSRNGR EN SM,MCANGUS TNP,COLEBATCH JG Vestibularevoked extraocular potentials produced by stimulation with boneconducted sound.Clin Neurophysiol,2005;116:1938-1948.
3 DERIU F,ORTU E,CAPOBIANCO S,et al.Origin of sound-evoked EMG responses in human masseter muscles.J Physiol,2007;580:195-209.
4 Fang Z.M.,C.X.,Gu X.,et al.A new magnetic resonance imaging scoring system for perilymphatic space appearance after intratympanicgadolinium injection,and its clinical application.Laryngol Otol,2012;126(5):454-459.
5 Xi Chen,Xiao-Dong Zhang,Xi Gu,et al.Endolymphatic Space Imaging in Idiopathic Sudden Sensorineural Hearing Loss With Vertigo.Laryngoscope,2012;122(10):2265-8.
6 XGU,Z-M FANG,X CHEN,et al.Diagnostic value of three-dimensional magnetic resonance imaging of inner ear after intratympanic gadolinium injection,and clinical application of magnetic resonance imaging scoring system in patients with delayed endolymphatic hydrops.The Journal of Laryngology&Otology,2014,128(1):53-59.
7 李婧,杨旭,吴子明.眼源性前庭诱发肌源性电位.中华耳科学杂,2014,12(2):231-234.
8 Nakashima T,Naganawa S,Pyykko I,etal.Grading of endolymphatic hydrops using magnetic resonance imaging.Acta Oto Laryngologica,2009;129:5-8.
9 Rosengren SM,Mc Angus Todd NP,Colebatch JG.Vestibular evoked extraocular potentials produced by stimulation with bone-conducted sound.Clinical Neurophysiology,2005;116(8):1938-1948.
10 Murofushi T,Nakahra H,Yoshimura E,et al.Association of air-conducted sound o VEMP findings with c VEMP and caloric test findings in patients with unilateral peripheral vestibular disorders.Acta Laryngology,2011;131(9):945-950.
11 Iwasaki S,Smulders YE,Burgess AM,et al.Ocular vestibular evoked myogenic potentials to bone conducted vibration of the midline forehead at Fz in healthy subjects.Clin Neurophysiol,2008;119(9):2135-2147.
12 Chihara Y,Iwasaki S,Ushio M,et al.Vestibular-evoked extraocular potentials by air-conducted sound:Another clinical test for vestibular function.Clinical Neurophysiology,2007;118(12):2745-2751.
13 Chihara Y,Iwasaki S,Ushio M,et al.Ocular vestibular-evoked myogenic potentials(o VEMPs)require extraocular muscles but not facial or cochlear nerve activity.Clin Neurophysiol,2009;120(3):581-587.
14 Amikulec A,Kowalczyk KA,Pfitzinger ME,et al.Negative association between treated osteoporosis and benign paroxysmal positional vertigo in women.J Laryngol Otol,2010;124(4):374-376.
15 Rosengren SM,Mc Angus Todd NP,Colebatch JG.Vestibular evoked extraocular potentials produced by stimulation with bone-conducted sound.Clinical Neurophysiology,2005;116(8):1938-1948.
16 Schuknecht HF,Gulya AJ.Endolymphatic hydrops.An overview and classification.Ann Otol Rhinol Laryngol Suppl,1983;106:1-20.
17 吴子明,张素珍,杨伟炎,等.膜迷路积水的实验室检查.临床耳鼻喉头颈外科杂志,2007,21(7):333-336.
18 Taylor RL,Wijewardene AA,Gibson WPR,et al.The vestibular evokedpotential profile of Meniere’s disease.Clin Neurophysiol,2011;12:1256-1263.
19 Winters SM,Campschroer T,Grolman W,Klis SFL.Ocular vestibular evoked myogenic potentials in response to air-conducted sound in Meniere’s disease.Otol Neurotol,2011;32:1273-1280.
20 郭维维,张素珍,李兴启.瞬态耳声发射主频对梅尼埃病的诊断价值.听力学及言语疾病杂志,1998,6(4):174-176.
21 Wang SJ,Weng WJ,Jaw FS,Young YH.Ocular and vestibular evoked myogenic potentials:a study to determine whether air-or bone-conducted stimuli are optimal.Ear Hear,2010;31:283-288.
22 Akkuzu G,Akkuzu B,Ozluoglu LN.Vestibular evoked myogenic potentials in benign paroxysmal positional vertigo and Meniere’s disease.Eur Arch Otorhinolaryngol,2006;263:510-517.
23 Young YH,Huang TW,Cheng PW.Assessing the stage of Meniere’s disease using vestibular evoked myogenic potentials.Arch Otolaryngol Head Neck Surg,2003;129:815-818.
24 Rauch SD,Zhou G,Kujawa SG,Guinan JJ,Herrmann BS.Vestibular evoked myogenic potentials show altered tuning in patients with Meniere’s disease.Otol Neurotol,2004;25:333-338.
25 Lin MY,Timmer FC,Oriel BS,et al.Vestibular evoked myogenic potentials(VEMP)can detect asymptomatic saccular hydrops.Laryngoscope,2006;116:987-992.
26 Huppert D,Strupp M,Brandt T.Long-term course of Meniere’s disease revisited.Acta Otolaryngol,2010;130:644-651.