目的:特发性突发性感音神经性耳聋(ISSHL)不仅对听觉功能造成急性损害,还会对前庭功能除损害听力功能外。这项研究的目的是使用热量测试和视频头脉冲测试对特发性突发性感音神经性听力损失患者进行前庭评估。此外,评估头晕与前庭测试和前庭测试治疗后反应的关系。
方法:这是一个观察性的,纵向和前瞻性研究,包括诊断为特发性突发性感觉神经性听力的患者。根据出现前庭主诉的情况将患者分为两组:第1组:前庭主诉患者,第2组:无前庭主诉的患者。所有受试者都接受了纯音测听(PTA)测试,在入院期间和第10天进行冷热量测试和视频头脉冲测试(vHIT),第三个月,以及他们随访门诊控制的第1年。根据Jongkees公式量化了热量测试响应中的单侧弱点(UW)。
结果:在第10天,根据ASHA标准治疗前的听力损失程度与根据Siegel标准产生的改善水平之间发现了积极且显着的关系,第三个月,治疗后第1年(分别为p=0.001,p=0.001,p<0.001)。当治疗后评估短期和长期结果时,观察到听力损失程度有积极改善.在治疗前,第1组和第2组之间观察到统计学上的显着差异,10天,比较治疗后3个月和1年的热量测试UW值(分别为p=0.020,p=0.004,p=0.004,p=0.004)。在治疗前,第1组和第2组之间观察到统计学上的显着差异,10天,比较治疗后3个月和1年vHIT侧管VOR值(分别为p=0.000,p=0.001,p=0.000,p=0.004)。当治疗后评估短期和长期结果时,在热量测试结果和侧向vHITVOR值均观察到正改善.预处理,治疗后第10天,第三个月,所有患者的第1年vHIT前后管VOR值为VOR≥0.8。前后管VOR值无差异。
结论:通过热量测试和vHIT客观证实,ISSHL患者的眩晕可以被认为是严重耳蜗损伤的征兆。我们的研究表明,ISSHL患者的前庭影响风险显着增加,尤其是有眩晕的时候.因此,我们得出的结论是,ISSHL的重点不仅应该放在耳蜗上,而且应该放在前庭系统上。
OBJECTIVE: Idiopathic sudden sensorineural hearing loss (ISSHL) can cause acute damage not only to the auditory function, but also to the vestibular function in addition to damage to the hearing function. The aim of this
study was to perform vestibular assessment using caloric test and video head impulse test in patients with idiopathic sudden sensorineural hearing loss. In addition, to evaluate the relationship of dizziness with vestibular tests and post-treatment responses of vestibular tests.
METHODS: This is an observational, longitudinal and prospective
study, including patients diagnosed with idiopathic sudden sensorineural hearing. Patients were divided into two groups according to the presence of vestibular complaints at presentation: Group 1: Patients with vestibular complaints, Group 2: Patients without vestibular complaints. All subjects underwent pure tone audiometry (PTA) testing, cold caloric test and video head impulse test (vHIT) during their admission and on the 10th day, 3rd month, and 1st year of their follow-up outpatient clinic controls. A unilateral weakness (UW) in the caloric test response was quantified according to the Jongkees formula.
RESULTS: A positive and significant relationship was found between the degree of hearing loss according to the ASHA criteria pre-treatment and the level of improvement created according to Siegel criteria at the 10th day, 3rd month, 1st year after treatment (respectively p = 0.001, p = 0.001, p < 0.001). When both short-term and long-term results were evaluated after treatment, a positive improvement in the degree of hearing loss was observed. A statistically significant difference was observed between Groups 1 and 2 when the pre-treatment, at 10 days, 3 months and 1 year after treatment the caloric test UW value was compared (respectively p = 0.020, p = 0.004, p = 0.004, p = 0.004). A statistically significant difference was observed between Groups 1 and 2 when the pre-treatment, at 10 days, 3 months and 1 year after treatment vHIT lateral canal VOR value was compared (respectively p = 0.000, p = 0.001, p = 0.000, p = 0.004). When both short-term and long-term results were evaluated after treatment, a positive improvement was observed in both caloric test results and lateral vHIT VOR values. Pre-treatment, post-treatment 10th day, 3rd month, 1st year vHIT anterior and posterior canal VOR values were found to be VOR˃0.8 in all patients. No difference was observed in anterior and posterior canal VOR values.
CONCLUSIONS: Vertigo in patients with ISSHL \"as objectively confirmed through caloric testing and vHIT\" can be considered a sign of severe cochlear damage. Our
study demonstrated a significantly increased risk of vestibular affect in patients with ISSHL, especially in the presence of vertigo. Thus, we conclude that the focus in ISSHL should not only be on the cochlea but also on the vestibular system.