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目的观察突聋患者的前庭功能,探究前庭诱发肌源性电位(VEMPs)与临床特征及预后之间的关系。方法回顾性分析52例全频听力下降的单耳突聋患者,所有患者入院时行VEMPs检查,并按听力分型治疗14天。比较不同分组中VEMPs各参数的差异,分析患者双耳间VEMPs的差异及VEMPs的结果与听力类型、是否伴眩晕、预后情况的关系。结果全聋型患者cVEMP、oVEMP的异常率显著高于平坦型患者(P=0.006、0.000),主要表现为cVEMP的引出率低、振幅小,oVEMP的P1潜伏期、N1潜伏期长;突聋伴眩晕患者cVEMP、oVEMP的异常率与不伴眩晕患者之间存在显著差异(P=0.035、0.023),主要表现为VEMPs的引出率降低;VEMPs正常组与异常组间的有效率无显著差异,但cVEMP正常患者的痊愈率为31.4%,异常患者的痊愈率为0%,差异显著(P=0.025)。结论全聋型和伴眩晕的突聋患者前庭功能受累较重,部分不伴眩晕患者也具有前庭功能的损伤;cVEMP检查结果正常者痊愈率更高。
Abstract：Objective To study the characteristics of vestibular function in patients with sudden hearing loss(SHL) and to discuss the relationship between vestibular evoked myogenic potentials and hearing loss type, vertigo and prognosis. Methods Data from 52 patients with unilateral SHL affecting all frequencies were analyzed retrospectively.All patients underwent vestibular evoked myogenic potential tests(cVEMP and oVEMP) and received treatment tailored to their types of hearing loss for 14 days. VEMP parameters were compared among patients with different types of hearing loss in an attempt to identify relationships between VEMPs and the type of hearing loss, vertigo and prognosis.Results The rate of abnormal cVEMP(absence or low amplitudes) and oVEMP(prolonged latencies) results in patients with total deafness was significantly higher than those with flat hearing loss(P=0.006 and P=0.000, respectively), and between patients with vertigo(mainly decreased rate of responses) and those without vertigo(P=0.035 and P=0.023, respectively). There was no significant difference in the prognosis between patients showing normal and those showing abnormal VEMPs. Hearing in some patients with normal cVEMP(31.4%) recovered completely, but not in any patients with abnormal cVEMP(P=0.025). Conclusion In SHL, patients showing total deafness or with vertigo have worse vestibular function. Patients without vertigo may also have vestibular dysfunction. The rate of complete hearing recovery in patients with normal cVEMP responses is higher than those with abnormal responses.
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基本信息:
中图分类号:R764.437
引用信息:
[1]李端超,何婧,章碧云,等.VEMPs在全频听力下降突发性聋中的应用研究[J].中华耳科学杂志,2020,18(05):866-870.
2020-10-15
2020-10-15