摘要
目的:分析良性阵发性眩晕(BPVC)患儿的视频头脉冲试验(vHIT)结果,探讨BPVC的可能发病机制,以及vHIT在儿童BPVC诊断中的临床价值。方法:36例BPVC患儿均进行头颅CT或MRI、脑电图、纯音测听、声导抗和vHIT检查。以vHIT增益值、增益不对称比和代偿性扫视眼动波(显性或隐性)作为研究的终点指标,分析BPVC患儿3对半规管功能异常情况。随机选取11例正常儿童作为正常对照组,对比分析两组间vHIT结果的差异。结果:①正常对照组vHIT各项指标均未见异常;BPVC组有9例(25.0%)异常,其中3例表现为增益值降低,4例表现为不对称比的异常,2例出现显性扫视波。②BPVC组水平左侧、水平右侧、左前、右后、右前、左后6个半规管的平均增益值和标准差分别为1.03±0.14、1.01±0.15、1.13±0.31、1.18±0.36、1.21±0.33和1.14±0.30,正常对照组分别为1.14±0.15、1.18±0.09、1.16±0.30、1.18±0.40、1.34±0.26和1.30±0.20,两组间水平半规管增益值差异均有统计学意义(P<0.05),余各半规管的增益值差异均无统计学意义(P>0.05)。③BPVC组双侧水平、左前右后、右前左后三对共轭半规管不对称比分别为0.04±0.07、0.06±0.04和0.06±0.04,正常对照组分别为0.02±0.02、0.04±0.03和0.04±0.04,差异均无统计学意义(P>0.05)。结论:BPVC的发病机制尚不清楚,存在一定比率的外周前庭功能异常。相比较冷热试验及其他前庭功能检查,vHIT试验相对简单且易于操作,可用于检测儿童6个半规管的功能异常情况,为评估BPVC患儿的外周前庭功能障碍提供一些潜在的临床信息。
Objective:This study was to analyze the results of video head impulse test(vHIT)of benign paroxysmal vertigo of childhood(BPVC)in order to determine the potential value of vHIT in the diagnosis and treatment for BPVC and to discuss its possible pathogenesis of BPVC.Method:Thirty-six children with BPVC were enrolled.No hearing loss and skull abnormality were found in these children as assessed by pure tone audiometry,acoustic impedance,CT or MRI scan.The vHIT was carried out,and main outcome measures were the gain of vestibulo-ocular reflex,gain asymmetry,and refixation saccades.Eleven healthy children were selected as normal control who came to our hospital for doing a routine checkup and have no history of dizziness.The differences of vHIT results between these two groups were analyzed.Result:①The vHIT results in control group were normal.In all BPVC subjects,abnormalities were detected in 9 patients(25.0%),including vHIT gains decline in 3 patients,abnormal symmetry in 4 patients,and abnormal isolated overt saccades in 2 patients.②The average saccadic gain in different canals of BPVC group was 1.03±0.14,1.01±0.15,1.13±0.31,1.18±0.36,1.21±0.33,1.14±0.30 in left horizontal,right horizontal,left anterior,right posterior,right anterior,left posterior canal,respectively;while in normal group,it was 1.14±0.15,1.18±0.09,1.16±0.30,1.18±0.40,1.34±0.26,1.30±0.20,respectively.Significant statistical difference was found only in horizontal canals between these two groups(P<0.05).③Asymmetry of the three pairs of conjugated semicircular canals was 0.04±0.07(horizontal canal),0.06±0.04(left anterior and right posterior canal),0.06±0.04(right anterior and left posterior canal)in BPVC group,respectively;while in control group,it was 0.02±0.02,0.04±0.03,0.04±0.04,respectively.There was no statistical difference between the two groups(P>0.05).Conclusion:A certain proportion of abnormal peripheral vestibule function in children with BPVC was found.vHIT is a 'child friendly', relatively easy-to-use,and simpl
作者
陈建勇
杨军
张勤
汪玮
马孝宝
梅玲
沈佳丽
沈敏
陈向平
CHEN Jianyong;YANG Jun;ZHANG Qin;WANG Wei;MA Xiaobao;MEI Ling;SHEN Jiali;SHEN Min;CHEN Xiangping(Department of Otolaryngology Head and Neck Surgery,Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Institute of Ophthalmology,School of Medicine,Shanghai Jiaotong University,Shanghai key Laboratory of Ear and Nose Disease Transformation,Shanghai,200092,China)
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2019年第3期232-236,共5页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
基金
国家自然科学基金面上项目(No:81470689)
上海交通大学科技创新专项资金多学科交叉项目(No:ZH2018ZDA11)
关键词
儿童
眩晕
视频头脉冲试验
child
vertigo
video head impulse test
