■通过确定每个半规管的前庭-眼反射的任何差异,扩大我们对前庭神经炎和迷路炎的病理生理机制的理解。
■回顾性分析。
■耳鼻咽喉头颈外科,朝鲜大学医院,从2015年1月到2021年12月。
■我们纳入了23例住院前庭神经炎和27例迷路炎患者。纯音测听,双热测试,在症状出现后5天内进行视频头部冲动测试。
■在前庭神经炎组中,平均前庭-眼反射增益在同侧水平管中下降到0.51,在前管中下降到0.55,导致明显的不对称,而同损后管的增益相对保留在0.85。在迷路炎组中,平均前庭眼反射增益为0.72,同损前管0.73,在同损后管为0.55。我们观察到两组之间三个半规管的前庭眼反射增益和同侧矫正扫视发生率的统计学差异(对于水平管,p=.002,前管p=.003,后管p<.001)。接收机工作特性曲线表明,纯音测听,同质后管增益,后管的增益不对称性是区分迷路炎和前庭神经炎的极好参数。
■前庭神经炎和迷路炎患者在三个半规管中均有不同程度和模式的视频头脉冲测试受累,这表明这两种不同的疾病可能有不同的病因。
UNASSIGNED: To expand our understanding of the pathophysiological mechanisms underlying vestibular neuritis and
labyrinthitis by identifying any difference in the vestibulo-ocular reflex for each semicircular canal.
UNASSIGNED: Retrospective analysis.
UNASSIGNED: The Department of Otorhinolaryngology - Head and Neck Surgery, Chosun University Hospital, from January 2015 to December 2021.
UNASSIGNED: We included 23 vestibular neuritis and 27
labyrinthitis patients who had been hospitalized. Pure-tone audiometry, a bithermal caloric test, and a video head-impulse test were performed within 5 days of symptom onset.
UNASSIGNED: In the vestibular neuritis group, mean vestibulo-ocular reflex gains were decreased to 0.51 in the ipsilesional horizontal canal and 0.55 in anterior canal, leading to marked asymmetry, whereas the gain of the ipsilesional posterior canal was relatively preserved at 0.85. In the
labyrinthitis group, the mean vestibulo-ocular reflex gain was 0.72 in the ipsilesional horizontal canal, 0.73 in the ipsilesional anterior canal, and 0.55 in the ipsilesional posterior canal. We observed statistical differences in the vestibulo-ocular reflex gain and incidence of corrective saccades on the ipsilesional side in three semicircular canals between the groups (p = .002 for horizontal canal, p = .003 for anterior canal, and p < .001 for posterior canal). The receiver operating characteristic curve showed that pure-tone audiometry, ipsilesional posterior canal gain, and gain asymmetry of posterior canal were excellent parameters for distinguishing
labyrinthitis from vestibular neuritis.
UNASSIGNED: Vestibular neuritis and
labyrinthitis patients have different degrees and patterns of video head-impulse test involvement in the three semicircular canals, suggesting that the two distinct disorders may have different etiologies.