The Chiari I malformation and the neurotologist
The Chiari I malformation and the neurotologist
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DOI：
10.1097/00129492-200209000-00021
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发表时间：
2002-09-01
影响因子：
2.1
通讯作者：
Charbel, F
中科院分区：
文献类型：
--
作者：
Kumar, A;Patni, AH;Charbel, F
目的：本文的第一个目的是报告77例患者的临床症状和结果，他们的神经，前庭和听力评估与磁共振成像，证实基亚里I畸形。第二个目的是报告前庭评估的结果如何帮助神经外科医生决定是否需要手术治疗。研究设计：回顾性病历回顾1988年至2000年期间观察到的77例患者。设置：三级护理中心。患者：对诊断为基亚里I畸形的患者的临床数据进行分析，并将其存档在前庭实验室计算机中。干预：本研究中的病例来自于Torok前庭实验室评估头晕、听力损失和耳鸣的患者人群。主要结果测量：基亚里I畸形患者中前庭中枢发现的发生率结果：在这组77名患者中，10名患有双侧感音神经性听力损失，22名患有不同严重程度的单侧感音神经性听力损失。水平自发性眼震27例，垂直上搏性眼震3例，下搏性眼震4例。4例患者出现扫视性辨距障碍，3例患者出现视动性眼震受损，12例患者出现平滑追踪功能受损。9例患者出现位置性眼球震颤。Torok单稳态冷热试验正常反应19例，多动反应43例，减少反应45例，反跳性冷热眼震20例。手术减压的基亚里I畸形完成33 patients.Conclusion：从这项研究中，很明显，基本前庭功能测试电池的结果反映了前庭小脑的功能缺陷，这是假定其异位位置。这些测试结果为我们的神经外科医生提供了一个更强大的基础，可以为这种疾病做出手术决策。
Objective: The first objective of this paper is to report the clinical symptoms of 77 patients and the results of their neurologic, vestibular, and audiological evaluations done with magnetic resonance imaging, which confirmed Chiari I malformations. The second objective is to report how the results of a vestibular evaluation can help neurosurgeons decide on the need for surgical treatment.Study Design: Retrospective chart review of 77 patients seen between 1988 and 2000.Setting: Tertiary care center.Patients: The clinical data of patients under diagnoses of Chiari I malformation, which was filed in the vestibular laboratory computer, was analyzed.Intervention: The cases included in this study were derived from a population of patients who were evaluated for dizziness, hearing loss, and tinnitus in the Torok Vestibular Laboratory.Main Outcome Measure: Occurrence of central vestibular findings in the patients with Chiari I malformationResults: In this group of 77 patients, 10 had bilateral sensorineural hearing loss and 22 had unilateral sensorineural hearing loss of varying severities. Horizontal spontaneous nystagmus was noted in 27 patients, vertical upbeat nystagmus in 3, and downbeat nystagmus in 4 others. Saccadic dysmetria was noted in 4 patients, optokinetic nystagmus was impaired in 3, and smooth-pursuit impairment was noted in 12 of the group. Positional nystagmus was noted in 9 patients. The Torok monothermal caloric test showed normal responses in 19 patients, hyperactive responses in 43, decruitment in 45, and rebound caloric nystagmus in 20. Surgical decompression of the Chiari I malformation was completed in 33 patients.Conclusion: From this study it is clear that the results of the basic vestibular function-test battery reflect the functional deficit in the vestibulocerebellum that is presumed by its ectopic position. These tests results have given our neurosurgeons a stronger foundation on which to base surgical decisions for this disease.