vestibular function test

前庭功能测试
  • 文章类型: English Abstract
    Objective:This study was conducted to evaluate the applications of vestibular function tests in diagnosis, identifying tumor origins and prognosis of vestibular rehabilitation of patients with acoustic neuroma. Methods:This research is a single-center cross-sectional clinical study, which retrospectively analyzed the data of 335 patients with acoustic neuroma from March 2013 to March 2020 in the Eye and ENT Hospital of Fudan University. The study included caloric test, cervical and ocular vestibular evoked myogenic potentials(cVEMP, oVEMP), video head impulse test(vHIT) and sensory organization test(SOT). Firstly, the sensitivity, specificity, and Yoden index of each test were calculated. Secondly, the internal relevance of these tests was studied for application in judging the origins of the tumor. Results:The abnormal rates of caloric test, cVEMP, oVEMP, vHIT and SOT was 85.3%, 86.1%, 85.5%, 55.6% and 67.7% in these participants. Among all the vestibular function tests included, the caloric test showed the best sensitivity(0.855), specificity(0.981), and Yoden index(0.836). The study found that the higher the Koos grades, the higher the abnormal rates of the caloric test, vHIT, and oVEMP(Cochran-Armitage test, P<0.05). There was no significant relationship between the combination of abnormal vestibular function tests and tumor origin nerves(P>0.05). Conclusion:Majorlty of the participants in this study with acoustic neuroma showed abnormal results in SOT related to poor balance control. More than half of the patients had at least two abnormal result of the battery of vestibular function tests, among which the caloric test was proved to have better sensitivity and specificity. The higher the Koos grades of the tumor, the higher the abnormal rates of the caloric test, vHIT, and oVEMP.
    目的:通过对听神经瘤患者前庭功能进行多方面评估,探究不同前庭检测技术在前庭功能障碍诊断、代偿建立及肿瘤起源分析中的价值,为听神经瘤患者的前庭功能预后评价及康复策略提供借鉴。 方法:回顾性分析2013年3月—2020年3月复旦大学附属眼耳鼻喉科医院耳鼻喉科收治的335例听神经瘤患者的多种术前前庭功能检查结果,包括温度试验、颈性前庭诱发肌源性电位(cVEMP)、眼性前庭诱发肌源性电位(oVEMP)、视频头脉冲试验(vHIT)及感觉统合试验(SOT),研究其在听神经瘤侧别判断中的灵敏度、特异度和约登指数等,分析各项检查的内部相关性,以及在肿瘤起源判断中的价值,并根据SOT结果对患者前庭代偿情况进行总结。 结果:入组患者中温度试验、cVEMP、oVEMP、vHIT、SOT检查异常率依次为85.3%、86.1%、85.5%、55.6%和67.7%,其中温度试验表现出相对最优的灵敏度(0.855)、特异度(0.981)和约登指数(0.836)。相关性分析结果提示随听神经瘤Koos分级增加,温度试验、vHIT和oVEMP检查异常率也在增加(Cochran-Armitage趋势检验,P<0.05)。各项前庭功能检查异常与对应肿瘤来源神经之间未见显著相关性(P>0.05)。 结论:多数听神经瘤患者术前存在前庭相关平衡障碍。超过50%的患者存在两项及以上前庭功能检查异常,提示前庭功能损伤范围较广。Koos分级越高,患者术前温度试验、vHIT和oVEMP检查异常率也更高。在判断患侧前庭功能异常方面,温度试验相对于cVEMP、oVEMP和vHIT检查显示出更佳的灵敏度与特异度。.
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  • 文章类型: Journal Article
    前庭神经鞘瘤(VS)是前庭神经的良性肿瘤。常见的首发症状是听力损失和耳鸣,其次是不平衡,眩晕,面神经受累.VS患者的主观症状与前庭病变的严重程度和前庭检查结果不一致,这通常会干扰临床医生的诊断。因此,VS的主要筛查和诊断方法是测听法和磁共振成像(MRI),忽略了对病理性病变源头前庭功能的评价。随着前庭评估技术的发展和完善及其在临床上的广泛应用,现代前庭检查技术可以从多个角度反映前庭病变的严重程度和发生频率,为前庭疾病的诊断和治疗提供客观依据。在这份报告中,我们回顾了VS患者前庭检查的结果和特点,并进一步阐明了前庭功能评估在VS诊断和治疗中的临床价值。
    Vestibular schwannomas (VS) are benign tumors of the vestibular nerve. The common first symptoms are hearing loss and tinnitus, followed by imbalance, vertigo, and facial nerve involvement. The subjective symptoms of VS patients are not consistent with the severity of vestibular lesions and the results of vestibular tests, which often interfere with clinicians\' diagnoses. Thus, the main screening and diagnostic methods for VS are audiometry and magnetic resonance imaging (MRI), ignoring the evaluation of vestibular function at the source of pathological lesions. With the development and improvement of vestibular evaluation technology and its wide application in the clinic, modern vestibular examination technology can reflect the severity and frequency of vestibular lesions and compensation from multiple perspectives, providing an objective basis for the diagnosis and treatment of vestibular diseases. In this report, we review the results and characteristics of vestibular tests in VS patients and further clarify the clinical value of vestibular function assessment in the diagnosis and treatment of VS.
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  • 文章类型: Journal Article
    OBJECTIVE: To investigate the correlation of 5-hydroxy tryptamine receptor 6 (5-HTR6) gene polymorphism with vestibular migraine (VM).
    METHODS: A total of 92 VM patients were enrolled as the observation group, and 100 healthy people receiving physical examinations as the control group. Their general clinical information was collected, and the level of 5-HT in plasma and the vestibular function test indexes were detected. Moreover, the polymorphism of 5-HTR6 rs770963777 was detected with the TaqMan-MGB probe.
    RESULTS: The observation group had a lower level of 5-HT than the control group (P < .05), and the abnormality rates of the vestibular function tests, including the caloric test, head-shaking test, and vestibular autorotation test, were obviously higher than those in the control group (P < .01). The comparisons showed that the distribution frequencies of the genotypes and alleles were different between the two groups (P < .05). According to the analysis of the genetic mode, there were differences in recessive and additive modes between the two groups (P < .05), but the dominant mode was not different between the two groups (P > .05).
    CONCLUSIONS: The level of 5-HT and the vestibular function test indexes can serve as the effective indicators for observing VM, and the polymorphism of 5-HTR6 rs770963777 site is correlated with VM onset.
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