Prevalence of vestibular dysfunction in patients with vestibular schwannoma using video head-impulses and vestibular-evoked potentials
Prevalence of vestibular dysfunction in patients with vestibular schwannoma using video head-impulses and vestibular-evoked potentials
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DOI：
10.1007/s00415-015-7697-4
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发表时间：
2015-05-01
影响因子：
6
通讯作者：
Welgampola, Miriam S.
中科院分区：
文献类型：
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作者：
Taylor, Rachael L.;Kong, Jonathan;Welgampola, Miriam S.
我们试图调查新的非侵入性测试的实用性，外耳道和耳石功能，可用于神经耳科诊所的做法，前庭神经鞘瘤患者。50例前庭神经鞘瘤患者使用5项电池进行评估，包括空气传导的颈部和骨传导的眼前庭诱发肌源性电位（AC cVEMPs和BC oVEMPs）和视频头脉冲测试（vHIT）在所有三个运河平面。VEMP不对称率，lavelet和vHIT增益被用来确定测试的灵敏度，与肿瘤大小和前庭神经受累的模式的关系。整个样本的五项检测中每项的异常百分比范围为36.2%-61.7%。在58.3%的患者中，测试异常可归因于上级和下前庭神经分支。选择性下神经功能障碍为10.4%，上级神经功能障碍为12.5%。其余18.8%的患者表现出正常的测试特征。5项组合的敏感性随着肿瘤的大小而增加，所有中到大（> 14 mm）神经鞘瘤患者至少有两个异常前庭试验结果。我们的研究结果表明，功能障碍的上级和前庭神经下的发展在大多数患者与神经鞘瘤平行。不明原因的vHIT和VEMP不对称应提醒耳科医生和神经科医生对非特异性平衡失调或眩晕患者进行成像。
We sought to investigate the utility of new non-invasive tests of semicircular-canal and otolith function that are usable in the neuro-otology office practice in patients with vestibular schwannoma. Fifty patients with vestibular schwannoma were assessed using a 5-item battery consisting of air-conducted cervical- and bone conducted ocular-vestibular-evoked myogenic potentials (AC cVEMPs and BC oVEMPs) and video head impulse testing (vHIT) in all three canal planes. VEMP asymmetry ratios, latencies, and vHIT gains were used to determine the test sensitivity, relationship with tumour size and the pattern of vestibular nerve involvement. The percentage of abnormalities for each of the five tests for the entire sample ranged between 36.2-61.7 %. In 58.3 % of patients, test abnormalities were referable to both superior and inferior vestibular nerve divisions. Selective inferior nerve dysfunction was identified in 10.4 % and superior nerve dysfunction in 12.5 %. The remaining 18.8 % of patients demonstrated a normal test profile. The sensitivity of the 5-item battery increased with tumour size and all patients with medium to large (> 14 mm) schwannoma had at least two abnormal vestibular test result. Our results indicate that dysfunction of the superior and inferior vestibular nerve evolves in parallel for most patients with schwannoma. Unexplained vHIT and VEMP asymmetry should alert otologists and neurologists to undertake imaging in patients presenting with non-specific disequilibrium or vertigo.