We retrospectively analyzed patients who had vertigo, unilateral tinnitus, or hearing loss and exhibited vascular contact of the 8th cranial nerve by MRI. Participants were classified into the VP or non-VP group according to the criteria of the Bárány Society in 2016. The demographic characteristics and audiological and electrophysiological test results of the two groups were compared. Receiver operating characteristic (ROC) curves were calculated for ABR to determine the best parameters and cutoff values to predict the existence of pathological neurovascular contact in VP.
Thirteen patients in the VP group and 66 patients in the non-VP group were included. VP patients had longer interpeak latency (IPL) I-III and wave III latency compared to non-VP patients (p < 0.001; p < 0.001). According to the ROC analyses, IPL I-III and wave III latency were the best indicators for the diagnosis of VP. The optimal cutoff for IPL I-III was 2.3 ms (sensitivity 84.6%, specificity 95.5%), and that for wave III latency was 4.0 ms (sensitivity 92.3%, specificity 77.3%). There were no differences in the PTA, caloric test, o-VEMP, or c-VEMP results between the two groups.
Prolonged IPL I-III and the wave III latency of ABR strongly suggested that vascular contact of the 8th cranial nerve was pathological, which may provide some references for microvascular decompression surgery of VP.
我们回顾性分析了眩晕患者,单侧耳鸣,或听力损失,并通过MRI显示第8颅神经的血管接触。根据2016年BáránySociety的标准,参与者被分为VP或非VP组。比较两组的人口学特征以及听力学和电生理测试结果。计算ABR的受试者工作特征(ROC)曲线,以确定最佳参数和临界值,以预测VP中病理性神经血管接触的存在。
包括VP组13例患者和非VP组66例患者。与非VP患者相比,VP患者的峰间潜伏期(IPL)I-III和III波潜伏期更长(p<0.001;p<0.001)。根据中华民国的分析,IPLI-III和III波潜伏期是诊断VP的最佳指标。IPLI-III的最佳截止值为2.3ms(灵敏度为84.6%,特异性95.5%),III波潜伏期为4.0ms(灵敏度为92.3%,特异性77.3%)。PTA没有差异,热量测试,o-VEMP,或两组之间的c-VEMP结果。
延长的IPLI-III和ABR的波III潜伏期强烈提示第8脑神经的血管接触是病理性的,为VP微血管减压术提供参考。