Retro-labyrinthine Lesion Site Detected by Galvanic Vestibular Stimulation Elicited Vestibular-evoked Myogenic Potentials in Patients with Auditory Neuropathy
Retro-labyrinthine Lesion Site Detected by Galvanic Vestibular Stimulation Elicited Vestibular-evoked Myogenic Potentials in Patients with Auditory Neuropathy
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DOI：
10.1007/s11596-021-2411-5
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发表时间：
2021-08
影响因子：
2.4
通讯作者：
Zi-chen Chen;Yuzhong Zhang;Huandi Zhao;Xinyu Wei;T. Murofushi;Juan Hu;Ying Cheng;Feiyun Chen;Xin-da Xu;Min Xu;Qing Zhang
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文献类型：
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作者：
Zi-chen Chen;Yuzhong Zhang;Huandi Zhao;Xinyu Wei;T. Murofushi;Juan Hu;Ying Cheng;Feiyun Chen;Xin-da Xu;Min Xu;Qing Zhang
目的听神经病是一种独特的保留毛细胞功能的听力损失类型。这种情况的特征是存在耳声发射(OAE)或耳蜗微音响(CM)反应，并伴有严重的听性脑干反应(ABR)异常。第VIII脑神经的前庭分支和它所支配的结构也会受到影响。方法对14例(28耳)ANN患者进行了气导声(ACS)、前庭诱发肌源性电位(VEMP)和前庭电流(GVS)VEMP检测。结果14例(28耳)患者的气导声、前庭诱发肌源性电位和冷热试验缺失率分别为92.9%(26/28)、85.7%(24/28)、67.9%(19/28)和67.9%(19/28)。分别为53.6%(15/28)和61.5%(8/13)。球囊、前庭下神经、椭圆囊、前庭上神经和水平半规管功能受损的发生率分别为25.0%(7/28)、67.9%(19/28)、32.1%(9/28)、53.6%(15/28)和61.5%(8/13)。与正常对照组比较，AN患者的ACs-VEMPs和GVS-VEMPs均出现异常(出现率降低、阈值升高、潜伏期延长、波幅降低等)。在本研究中，更常见的是迷路后病变。GVS-VEMPs联合ACS-VEMPs可帮助确定病变部位，并有助于检测这些患者的前庭功能障碍区域。
ObjectiveAuditory neuropathy (AN) is a unique pattern of hearing loss with preservation of hair cell function. The condition is characterized by the presence of otoacoustic emissions (OAE) or cochlear microphonic (CM) responses with severe abnormalities of the auditory brainstem response (ABR). The vestibular branches of the VIII cranial nerve and the structures innervated by it can also be affected. However, the precise lesion sites in the vestibular system are not well characterized in patients with AN.MethodsThe air-conducted sound (ACS) vestibular-evoked myogenic potentials (VEMPs) and galvanic vestibular stimuli (GVS)-VEMPs were examined in 14 patients with AN.ResultsOn examination of VEMPs (n=14, 28 ears), the absent rates of ACS-cervical VEMP (cVEMP), ACS-ocular VEMP (oVEMP), GVS-cVEMP, GVS-oVEMP and caloric test were 92.9% (26/28), 85.7% (24/28), 67.9% (19/28), 53.6% (15/28), and 61.5% (8/13), respectively. Impaired functions of the saccule, inferior vestibular nerve, utricle, superior vestibular nerve, and horizontal semicircular canal were found in 25.0% (7/28), 67.9% (19/28), 32.1% (9/28), 53.6% (15/28) and 61.5% (8/13) patients, respectively. On comparing the elicited VEMPs parameters of AN patients with those of normal controls, both ACS-VEMPs and GVS-VEMPs showed abnormal results in AN patients (such as, lower presence rates, elevated thresholds, prolonged latencies, and decreased amplitudes).ConclusionThe study suggested that patients with AN often have concomitant vestibular disorders. Retro-labyrinthine lesions were more frequently observed in this study. GVS-VEMPs combined with ACS-VEMPs may help identify the lesion sites and facilitate detection of areas of vestibular dysfunction in these patients.