Abstract:
As previously reported, a single test measuring oVEMP n10 to 4000 Hz stimuli (bone-conducted vibration (BCV) or air-conducted sound (ACS)) provides a definitive diagnosis of semicircular canal dehiscence (SCD) in 22 CT-verified patients, with a sensitivity of 1.0 and specificity of 1.0. This single short screening test has great advantages of speed, minimizing testing time, and the exposure of patients to stimulation. However, a few studies of the 4000 Hz test for SCD have reported sensitivity and specificity values which are slightly less than reported previously. We hypothesized that the rise time of the stimulus is important for detecting the oVEMP n10 to 4000 Hz, similarly to what we had shown for 500 and 750 Hz BCV. We measured oVEMP n10 in 15 patients with CT-verified SCD in response to 4000 Hz ACS or BCV stimuli with rise times of 0, 1, and 2 ms. As a result, increasing the rise time of the stimulus reduced the oVEMP n10 amplitude. This outcome is expected from the physiological evidence of guinea pig primary vestibular afferents, which are activated by sound or vibration. Therefore, for clinical VEMP testing, short rise times are optimal (preferably 0 ms).
摘要:
正如以前报道的那样,测量oVEMPn10至4000Hz刺激(骨传导振动(BCV)或空气传导声音(ACS))的单个测试在22例CT证实的患者中提供了半规管开裂(SCD)的明确诊断,灵敏度为1.0,特异性为1.0。这种单一的短筛选试验在速度上有很大的优势,最小化测试时间,以及患者暴露于刺激中。然而,一些4000HzSCD试验的研究报告的敏感性和特异性值略低于以前的报道.我们假设刺激的上升时间对于检测oVEMPn10到4000Hz很重要,类似于我们对500和750HzBCV的显示。我们测量了15例经CT验证的SCD患者对4000HzACS或BCV刺激的反应的oVEMPn10,上升时间为0、1和2ms。因此,增加刺激的上升时间会降低oVEMPn10振幅。从豚鼠原发性前庭传入的生理证据可以预期这一结果,由声音或振动激活。因此,用于临床VEMP测试,较短的上升时间是最佳的(最好是0ms)。