Sound- and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal
Sound- and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal
复制标题
由于上半规管骨裂开而引起的声音和/或压力引起的眩晕
DOI：
10.1001/archotol.124.3.249
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发表时间：
1998-03-01
影响因子：
--
通讯作者：
Zee, DS
中科院分区：
文献类型：
--
作者：
Minor, LB;Solomon, D;Zee, DS
目的：介绍由于上级半规管上的骨裂开而引起的声音和/或压力诱导性眩晕患者的症状、眼球震颤模式和计算机断层扫描识别。描述的解剖结果和结果在2例患者进行封堵的上级半规管治疗这些symptoms.Design和设置：前瞻性研究的一个病例系列在三级护理referral center.Patients和结果：8例眩晕，眩晕，和/或不平衡相关的声音，中耳压力的变化，和/或颅内压的变化，确定在2年的时间。这些患者中的7例还出现了由这些声音和/或压力刺激引起的垂直扭转眼球运动。诱发眼运动的方向可以解释为受影响耳的上级半规管的兴奋或抑制。颞骨的电脑断层扫描确定了每例病例中覆盖受影响的上级半规管的骨裂开。2例患者的失能不平衡提示通过中颅窝入路封堵裂开的上级椎管。所有病例的症状均得到改善。一名患者复发的症状，需要额外的堵塞程序，并在这第二个procedure.Conclusions后几天开发感音神经性听力损失：我们已经确定了患者的前庭症状综合征引起的声音在耳朵或中耳或颅内压的变化。这些患者也可能经历慢性失衡。平行于上级半规管的平面中的眼球运动由刺激诱发，所述刺激有可能在存在覆盖管的骨裂开的情况下引起该管的壶腹偏离或向壶腹偏转。颞骨的计算机断层扫描证实了这种开裂的存在。对有致残症状的患者，手术堵塞受累根管可能是有益的。
Objectives: To present symptoms, patterns of nystagmus, and computed tomographic scan identification of patients with sound- and/or pressure-induced vertigo due to dehiscence of bone overlying the superior semicircular canal. To describe anatomical findings and outcome in 2 patients undergoing plugging of the superior semicircular canal for treatment of these symptoms.Design and Setting: Prospective study of a case series in a tertiary care referral center.Patients and Results: Eight patients with vertigo, oscillopsia, and/or disequilibrium related to sound, changes in middle ear pressure, and/or changes in intracranial pressure were identified in a 2-year period. Seven of these patients also had vertical-torsional eye movements induced by these sound and/or pressure stimuli. The direction of the evoked eye movements could be explained by excitation or inhibition of the superior semicircular canal in the affected ear. Computed tomographic scans of the temporal bones identified dehiscence of bone overlying the affected superior semicircular canal in each case. Disabling disequilibrium in 2 patients prompted plugging of the dehiscent superior canal through a middle cranial fossa approach. Symptoms were improved in each case. One patient developed recurrent symptoms requiring an additional plugging procedure and developed sensorineural hearing loss several days after this second procedure.Conclusions: We have identified patients with a syndrome of vestibular symptoms induced by sound in an ear or by changes in middle ear or intracranial pressure. These patients can also experience chronic disequilibrium. Eye movements in the plane parallel to that of the superior semicircular canal were evoked by stimuli that have the potential to cause ampullofugal or ampullopetal deflection of this canal's cupula in the presence of a dehiscence of bone overlying the canal. The existence of such deshiscences was confirmed with computed tomographic scans of the temporal bones. Surgical plugging of the affected canal may be beneficial in patients with disabling symptoms.