Vestibular evoked myogenic potentials in patients suffering from an unilateral acoustic neuroma: a study of 170 patients
Vestibular evoked myogenic potentials in patients suffering from an unilateral acoustic neuroma: a study of 170 patients
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DOI：
10.1016/s1388-2457(03)00119-6
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发表时间：
2003-07-01
影响因子：
4.7
通讯作者：
de Waele, C
中科院分区：
文献类型：
--
作者：
Patko, T;Vidal, PP;de Waele, C
目的：探讨叩击声和500 Hz短音脉冲诱发的前庭诱发肌电位（VEMP）对听神经瘤的诊断价值。方法：研究同侧胸锁乳突肌对100db轻击和500hz轻击的平均反应。该研究包括95名健康受试者和170名单侧听神经瘤患者。热量和听力测试结果也进行了分析。结果：36 /170例（21.2%）患者对点击和STB反应正常，134/170例（78.8%）患者反应异常低或无反应。78/170（45.9%）对点击和STB均无反应。在56/170例（32.9%）患者中，高水平咔哒声与STB诱发的VEMP不一致：对咔哒声反应异常（无反应n = 40或低反应n = 16）的患者中，STB诱发的VEMP正常（n = 32）或低（n = 24）。相比之下，stb诱发的VEMP在点击正常反应的情况下总是正常的。囊神经功能障碍与4-8 kHz听力损失程度或水平椎管损伤程度之间没有很强的系统相关性。结论：这些数据表明，高水平的咔哒声和STB提供了关于囊神经功能的补充信息。咔嗒声可用于检测轻微的囊神经功能障碍。在对咔哒声没有反应的情况下，STB提供了有关囊神经潜在残余功能的宝贵信息。(C) 2003年国际临床神经生理学联合会。爱尔兰爱思唯尔科学有限公司出版。版权所有。
Objective: To determine the value of investigating the vestibular evoked myogenic potentials (VEMP's) induced by clicks and 500 Hz short tone burst (STB) for the diagnosis of acoustic neuromas.Methods: We studied the average responses to 100 dB clicks and 500 Hz STB in the ipsilateral sternomastoid muscle. Ninety-five healthy subjects and 170 patients suffering from a unilateral acoustic neuroma were included in that study. Caloric and audiometric tests results were also analyzed.Results: Thirty-six/170 patients (21.2%) exhibited normal responses to clicks and to STB whereas 134/170 (78.8%) gave abnormally low or no responses. 78/170 (45.9%) showed no responses to both clicks and STB. In 56/170 patients (32.9%), VEMP's induced by high level clicks and STB were discordant: STB VEMP's were either normal (n = 32) or low (n = 24) in patients with an abnormal response to clicks (no response n = 40 or low response n = 16). In contrast, STB-induced VEMP's were always normal in cases of normal responses to clicks. No strong, systematic correlation could be found between saccular nerve dysfunction and either the degree of 4-8 kHz hearing loss or the extent of horizontal canalar impairment.Conclusions: These data indicate that high level clicks and STB provide complementary information about the functionality of the saccular nerve. Clicks are useful to detect a minor saccular nerve dysfunction. In cases in which there is no response to clicks, STB gives valuable information about a potential residual function of the saccular nerve. (C) 2003 International Federation of Clinical Neurophysiology. Published by Elsevier Science Ireland Ltd. All rights reserved.