目的 探讨外周性双侧前庭病的听-前庭功能特点及其在诊断中的价值.方法 对自2006年12月～2010年10月我科眩晕专科诊治的具步态不稳和振动幻视特征性症状的外周性双侧前庭病53例,行听-前庭功能检查和病因分析.结果 明确或可能病因42例(79.2％),原因不明者11例(20.8％).听力正常10例(18.9％)、异常43 (81.1％).冷热试验:双侧前庭功能低下共49例(92.5％),双侧前庭功能丧失4例(7.5％).头脉冲试验病理阳性38例(71.7％).接受动态姿势描记图检查39例,显示不同程度的前庭输入下降或前庭输入为主下降.结论 双侧前庭病的诊断根据病史、特征性的临床表现及听-前庭功能检查,冷热试验及头脉冲试验结合有诊断价值,听力学检查有助原发疾病的诊断.
Objective To investigate features of auditory-vestibular function in bilateral peripheral vestibulopathy and their values in the diagnosis. Methods Fifty-three patients with characteristic symptoms of oscillopsia and gait ataxia were diagnosed with peripheral bilateral vestibulopathy between December 2006 and October 2010. The auditory-vestibular function in these patients was analyzed, in an attempt to determine etiology. Results Among the 53 cases, definite or possible causes were identified in 42 cases (79.2%). No causes could be determined in 11 cases (20.8%). Hearing loss was seen in 37(81.1%) Vestibular function was low in 49 cases (92.5%) and completely lost in 4 cases (7.5%) bilaterally on caloric test. Thirty eight cases (71.7%) had pathological head impulse test (HIT). Posturography was conducted in 39 cases and showed various extents of vestibular input deficiency in all 39 cases. Conclusions The diagnosis of bilateral vestibulopathy is based on the history, characteristic symptoms and the results of auditory-vestibular function testing. Combined caloric test and HIT have the value to confirming the diagnosis. Audiometric tests can help discriminate the origin of disease.
区永康;陈玲;杨海弟;许耀东;朱洪蕾;郑亿庆
中山大学孙逸仙纪念医院耳鼻喉科,广州510120
医药卫生
双侧前庭病;诊断;听力学;前庭功能
Bilateral Vestibulopathy;Diagnosis;Audiology;Vestibular function
《中华耳科学杂志》 2011 (004)
394-397 / 4
广东省科技计划研究项目(2008B080703028)
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