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1.
Ann Otol Rhinol Laryngol ; 132(1): 41-49, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35114808

RESUMO

OBJECTIVES: To explore the usefulness of vestibular tests including "vestibular evoked myogenic potentials" (VEMPs) and the video head impulse test (vHIT) in the early diagnosis of "idiopathic Parkinson's disease" (PD). MATERIALS AND METHODS: The study involved 80 participants including 40 patients (24 males, 16 females; age average 63.20 ± 7.94 years) with PD and 40 healthy individuals (18 males and 22 females; age average of 60.36 ± 7.68 years). The Modified Hoehn and Yahr (H&Y) scale was used to measure how Parkinson's symptoms progress and the level of disability. Patients with PD underwent cVEMPs, oVEMPs, and vHIT and the results were compared with those of 40 age-matched healthy control (HC) subjects. vHIT results and VEMP responses were registered in all patients and HCs. RESULTS: One-sided absent cVEMP responses were found in 6 (15%) patients with PD and 8 (20%) patients had bilaterally absent responses. Five (12.5%) patients had 1-sided absent oVEMP responses and it was bilateral in 6 (15%). Patients with PD had significantly shorter cVEMP P1, N1 latency, lower cVEMP amplitudes, and oVEMP amplitudes than the HC group. The cVEMP and oVEMP amplitude asymmetry ratio was significantly higher in the PD group (P < .05). Evaluation of vHIT results and vestibular-ocular reflex (VOR) gain between the groups revealed that anterior canal and posterior canal VOR gains results were remarkably lower in the PD group than in the HCs (P < .05). There was no difference in right and left lateral canal VOR gains between the groups (P > .05). CONCLUSION: The results of this study suggest that cVEMP and vHIT can be used to evaluate the vestibular system in patients with early-stage Parkinson's disease.


Assuntos
Doença de Parkinson , Potenciais Evocados Miogênicos Vestibulares , Masculino , Feminino , Humanos , Pessoa de Meia-Idade , Idoso , Teste do Impulso da Cabeça/métodos , Doença de Parkinson/diagnóstico , Potenciais Evocados Miogênicos Vestibulares/fisiologia , Reflexo Vestíbulo-Ocular/fisiologia
2.
Vestn Otorinolaringol ; 87(5): 39-42, 2022.
Artigo em Russo | MEDLINE | ID: mdl-36404689

RESUMO

The study of vestibular function in patients with Meniere's disease (MD) is an urgent task, since it influences the choice of treatment tactic. We evaluated the results of caloric and video head impulse (vHIT) tests in 76 patients who met the clinical criteria for significant Meniere's disease (AAO-HNS modified by the Barany Society, 2015). Dissociation of the results of caloric and vHIT tests is observed in the majority (74%) of patients with MD: at normal gain, according to vHIT data, hypofunction of peripheral vestibular structures is recorded according to the caloric test (KASL 47 ± 7.8%). In patients with MD, vestibular dysfunction is observed mainly at low frequencies (0.003 Hz), therefore vHIT, which allows assessing horizontal semicircular canal function at high frequencies (3-5 Hz), is not an optimal study for assessing the degree of vestibular dysfunction in patients with MD.


Assuntos
Teste do Impulso da Cabeça , Doença de Meniere , Humanos , Teste do Impulso da Cabeça/métodos , Doença de Meniere/diagnóstico , Estudos Retrospectivos , Testes Calóricos/métodos , Canais Semicirculares
3.
Artigo em Chinês | MEDLINE | ID: mdl-36347579

RESUMO

Objective:To explore the correlation between the parameters of video head impulse test (vHIT)and dizziness handicap inventory (DHI) score in patients with vestibular neuritis. Methods:Clinical data of 46 patients with vestibular neuritis were retrospectively analyzed. All the patients underwent DHI evaluation and vHIT examination. They were divided into mild handicap group, moderate handicap group and severe handicap group according to DHI score. The correlations between the parameters of vHIT and DHI score were compared among the three groups. The important parameters of vHIT were compared including vestibulo-ocular reflex (VOR) gain, gain asymmetry ratio (GA), abnormal saccade dispersion (PR%). Results:Of the 46 patients, 10 were in the mild handicap group, 21 in the moderate handicap group, and 15 in the severe handicap group. ①In the comparison of the mean value of lateral semicircular canal VOR gain, the vHIT gain of patients with mild, moderate and severe handicap were 0.64±0.06, 0.53±0.11 and 0.37±0.10, respectively, the mean value of VOR gain was negatively correlated with DHI score among the three groups(r=-0.545, P<0.001), and the pairwise comparisons among the three groups was statistically significant(P<0.05). In comparison of the mean values of lateral semicircular canal GA, the GA values of mild, moderate and severe handicap groups were 46.40±21.81, 47.59±15.17 and 56.57±17.39, respectively, there was no significant linear correlation between GA values and DHI scores among the three groups(r=0.246, P>0.05), there was no significant difference between the three groups(P>0.05). In comparison of the mean PR% of the lateral semicircular canal, the mean PR% of patients with mild, moderate and severe handicap group were 32.00±10.62, 53.82±17.09 and 76.00±10.01, respectively, PR% was positively correlated with DHI score(r=0.726, P<0.001), and the comparison among the three groups was statistically significant(P<0.05). ②The vertical semicircular canal vHIT gain of patients with mild, moderate and severe handicap was 0.63±0.06, 0.52±0.15 and 0.38±0.16, respectively, the mean of VOR gain was negatively correlated with DHI score among the three groups(r=-0.487, P<0.01), the comparison of mild-severe and moderate-severe group was statistically significant(P<0.05), while there was no significant difference between the mild and moderate group(P>0.05). In the comparison of the mean values of vertical semicircular canal GA, the GA values of mild, moderate and severe handicap groups were 40.40±15.31, 46.10±19.59 and 47.87±18.05, respectively, there was no significant linear correlation between GA values and DHI scores among the three groups(r=0.047, P>0.05), there was no significant difference in GA among the three groups(P>0.05). The PR% of patients with mild, moderate and severe handicap were 42.40±15.39, 54.14±17.60 and 64.93±10.95, respectively, there was a positive significant correlation between PR% and DHI score(r=0.454, P<0.05), there was statistically significant in the comparison of mild-severe group(P<0.05), while there was no statistical significance between the other groups(P>0.05). Conclusion:The VOR gain and PR% value of vHIT in patients with vestibular neuritis are closely related to the DHI score, which can evaluate the vestibular function and the degree of vertigo.


Assuntos
Teste do Impulso da Cabeça , Neuronite Vestibular , Humanos , Neuronite Vestibular/diagnóstico , Estudos Retrospectivos , Reflexo Vestíbulo-Ocular , Vertigem/diagnóstico , Canais Semicirculares , Hiperplasia
4.
Turk J Med Sci ; 52(5): 1639-1645, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36422481

RESUMO

BACKGROUND: A growing number of vestibular function tests are utilized to differentiate and verify the diagnosis of vestibular neuritis. The aim of this study is to retrospectively investigate the consistency of the results of the objective vestibular test batteries in patients with a preliminary diagnosis of vestibular neuritis. METHODS: We reviewed a total of 37 adult patients (mean age: 39.03 ± 11.67, 19 females, 18 males) who met the inclusion criteria with a prediagnosis of vestibular neuritis from 379 patients suffering vestibular symptoms. Caloric test (CVT), video head impulse test (vHIT), and ocular and cervical VEMP tests were compared with Cohen's kappa (Κ) analysis according to the likely affected part of the vestibular nerve. RESULTS: The highest statistically significant K value was found between horizontal vHIT and ocular VEMP (K = 0.707; good grade, p < 0.05). All the tests compared with CVT were poorly in agreement (K = 0.288; 0.262; 0.256 for HvHIT, oVEMP, AvHIT, respectively, p < 0.05). DISCUSSION: VEMP and vHIT tests have prominent diagnostic value and agree with each other for detecting and differentiating the types of vestibular neuritis. Further studies should aim to include cutting-edge technologies such as functional HIT and ocular counter roll test.


Assuntos
Neuronite Vestibular , Adulto , Feminino , Humanos , Masculino , Testes Calóricos/métodos , Teste do Impulso da Cabeça/métodos , Estudos Retrospectivos , Nervo Vestibular , Neuronite Vestibular/diagnóstico
6.
J Am Acad Audiol ; 33(3): 116-124, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-36216039

RESUMO

BACKGROUND: To achieve balance, persons with blindness (PWB) use proprioceptive and vestibular cues rather than the visual system; however, PWB are equally susceptible to acquire vestibular disorders. Reliable assessments of the vestibular system in PWB are essential to determine the presence or absence of vestibular disorders. PURPOSE: The saccular and the utricular functioning can be assessed using cervical vestibular-evoked myogenic potential and ocular vestibular-evoked myogenic potential, respectively. Evaluation of the functional integrity of the semicircular canals requires an assessment of the vestibular ocular reflex; however, this can be challenging in PWB. Video head impulse test (vHIT) assesses the vestibular ocular reflex (VOR) elicited against the natural high-frequency head movement in the planes of all six semicircular canals. This study aimed to explore the feasibility and outcomes of administering vHIT in PWB. RESEARCH DESIGN: Standard (static) groups comparison. STUDY SAMPLE: Nineteen young PWB and 23 age-matched adults with "normal" vision (control group) were included in the study. DATA COLLECTION AND ANALYSES: PWB underwent vHIT once, while the control group was tested in three conditions; condition 1 was used to simulate blindness for the control group, where vHIT was done in a pitch-dark room without prior instructions; condition 2 included vHIT testing in daylight, without a fixed visual target and any instructions; and condition 3 involved vHIT in daylight in the presence of a set visual target and with standard instructions to maintain visual focus on the visual target. RESULTS: The VOR gain was abnormal in the PWB group for all the canals. Among the PWB, the lateral canals (mean = 0.63) had the best VOR gain, followed by the anterior canals (mean = 0.53) and the posterior canals (mean = 0.31). In the control group, the VOR gain was significantly reduced in condition 1. There was no significant difference between the VOR gain in the PWB group and the control group in condition 1 for the lateral and the anterior canals. A higher proportion of participants in the PWB group had the presence of refixation saccades. CONCLUSION: VOR is significantly reduced in PWB but not completely absent. There may be a need to develop normative data for blind individuals to decide whether or not a person with blindness has a vestibular dysfunction, specifically a VOR deficit.


Assuntos
Teste do Impulso da Cabeça , Doenças Vestibulares , Adulto , Cegueira , Estudos de Viabilidade , Humanos , Reflexo Vestíbulo-Ocular/fisiologia , Canais Semicirculares , Doenças Vestibulares/diagnóstico
7.
J Neurol Sci ; 442: 120417, 2022 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-36209570

RESUMO

The video head impulse test (vHIT) assesses the vestibulo-ocular reflex (VOR) during a rapid high-velocity low amplitude (10°-20°) head rotation. Patients with peripheral vestibulopathy have a reduced VOR gain with corrective catch-up saccades during the head turn. There are several pitfalls, mainly technical, which may interfere with interpretation of vHIT data. In addition, intrusive eye movement disorders such as spontaneous nystagmus that affect normal eye position and tracking can affect the vHIT results. To date there has been little study of neurological saccadic eye movements that may interfere with the interpretation of vHIT data. Here, in ten patients with a range of central neurological disorders, we describe oculomotor abnormalities on vHIT in the presence of normal range VOR gain values, recorded at a tertiary vestibular neurology service.


Assuntos
Nistagmo Patológico , Transtornos da Motilidade Ocular , Humanos , Teste do Impulso da Cabeça/métodos , Reflexo Vestíbulo-Ocular , Movimentos Sacádicos , Valores de Referência , Nistagmo Patológico/diagnóstico , Nistagmo Patológico/etiologia
8.
Otol Neurotol ; 43(9): 1065-1071, 2022 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-36075105

RESUMO

OBJECTIVES: This study was performed to evaluate the effectiveness of our novel group vestibular rehabilitation therapy (G-VRT) and to analyze the factors affecting outcomes. STUDY DESIGN: Retrospective case series. SETTING: Tertiary referral center. PATIENTS: Patients with chronic dizziness who received G-VRT between December 2019 and July 2020. INTERVENTION: The G-VRT program consisted of a 1-hour physical therapy session by an otologist in a small group setting. MAIN OUTCOME MEASURES: Dizziness Handicap Inventory, visual analog scale, functional level scales, and video head impulse test, as well as the compliance to the program, were evaluated. RESULTS: All scores of dizziness questionnaires were significantly improved after G-VRT ( p < 0.001). The overall vestibule-ocular reflex gain calculated by video head impulse test increased compared to the initial scores, whereas the average PR scores of all three semicircular canals significantly decreased from the initial scores, indicating enhanced vestibular compensation ( p < 0.05). Enrolled patients showed high compliance to the program. CONCLUSION: G-VRT program is a cost-effective and efficient way to provide relief for chronic dizzy patients. Further case-control studies in a larger group, as well as comparative studies with generic or customized vestibular exercise, will be needed to validate the clinical value of G-VRT.


Assuntos
Tontura , Doenças Vestibulares , Análise Custo-Benefício , Teste do Impulso da Cabeça , Humanos , Pacientes Ambulatoriais , Estudos Retrospectivos , Vertigem
9.
Otol Neurotol ; 43(8): 956-961, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-35960881

RESUMO

OBJECTIVE: This study reports subjective and objective audiovestibular function in patients diagnosed with an endolymphatic sac tumor (ELST), to evaluate the clinical implication of vestibular testing in ELST patients. STUDY DESIGN: Retrospective cohort study. SETTING: Tertiary referral center/university hospital. PATIENTS: Five patients diagnosed with unilateral ELST. INTERVENTION: Subjective and objective audiovestibular tests; pure-tone average; speech discrimination score; the Video Head Impulse Test; the cervical vestibular evoked myogenic potential test; the caloric irrigation test; the Speech, Spatial and Qualities of Hearing Scale; the Tinnitus Handicap Inventory; and the Dizziness Handicap Inventory. MAIN OUTCOME MEASURE: Findings and characteristics of both subjective and objective audiovestibular functions. RESULTS: The mean pure-tone average and the mean speech discrimination score were 49 dB HL and 68% on the tumor ear and 13 dB HL and 99% contralaterally. The mean Speech, Spatial and Qualities of Hearing Scale score was 84, and the mean Tinnitus Handicap Inventory score was 64. Caloric testing showed a mean unilateral weakness of 80%. The Video Head Impulse Test of the lateral semicircular canal revealed refixation saccades on all tumor ears and an average gain value of 0.75 on the tumor ear versus 0.94 contralaterally. No cervical vestibular evoked myogenic potentials were elicited on the tumor side, whereas all but one was elicited contralaterally. The average Dizziness Handicap Inventory score was 47. CONCLUSION: A characteristic pattern of abnormal caloric findings, refixation saccades, and normal vestibulo-ocular reflex gain alongside sensorineural hearing loss on the tumor ear was identified. Asymmetric sensorineural hearing loss in any patient should lead to objective vestibular evaluation to strengthen not only a targeted tumor surveillance strategy and the indication for imaging, but also the design of vestibular rehabilitation. In addition, vestibular findings may guide the choice of surgical approach.


Assuntos
Neoplasias da Orelha , Saco Endolinfático , Perda Auditiva Neurossensorial , Doenças do Labirinto , Zumbido , Potenciais Evocados Miogênicos Vestibulares , Tontura/diagnóstico , Tontura/epidemiologia , Tontura/etiologia , Teste do Impulso da Cabeça , Humanos , Estudos Retrospectivos , Zumbido/diagnóstico , Potenciais Evocados Miogênicos Vestibulares/fisiologia
10.
Artigo em Chinês | MEDLINE | ID: mdl-35959580

RESUMO

Objective:To explore the application value of video head impulse test(vHIT), caloric test(CT) and the dizziness handicap inventory(DHI) in the diagnosis of acoustic neuroma(AN), to analyze the correlation between vHIT and CT, and to determine the correlationsof tumor size, vHIT, CT and DHI score. Methods:The clinical data of 24 patients with AN who underwent surgery in our department from January 2019 to January 2022 were analyzed retrospectively, including craniocerebral MRI, vHIT, caloric test and DHI score. All the data were statistically analyzed by GraphPadPrism9.0. Results:There was a significant negative correlation between the UW value of CT and the vestibular eye reflex gain of vHIT(P<0.01, r=-0.62). The tumor size was significantly correlated with the increase of UW value of CT(P<0.01, r=0.69), and with the decrease of vestibulo-ocular reflex gain of vHIT(P<0.01, r=-0.53). The average Dizziness Handicap Inventory score was 8.9±16.2, which was not correlated with tumor size(P>0.05). Conclusion:Both vHIT and CT can effectively evaluate the vestibular function of patients with AN(and they are complementary), and they are related to the size of the tumor and have certain value in the diagnosis of acoustic neuroma.


Assuntos
Teste do Impulso da Cabeça , Neuroma Acústico , Testes Calóricos , Tontura/diagnóstico , Humanos , Neuroma Acústico/diagnóstico , Reflexo Vestíbulo-Ocular , Estudos Retrospectivos , Vertigem/diagnóstico
11.
J Int Adv Otol ; 18(5): 441-446, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35971266

RESUMO

The central vestibular compensation reduces vestibular symptoms and helps individuals improve balance affected by vestibular dysfunction. The video head impulse test provides an opportunity to study central vestibular compensation objectively. This study aims to methodically present existing information about the video head impulse test as a measure to evaluate central vestibular compensation in patients with unilateral vestibular dysfunction. Literature review comprised 12 research articles selected based on pre-set criteria and timeline (January 2010 to June 2020). The findings indicate that the appropriate video head impulse test measures to evaluate central vestibular compensation after the occurrence of temporary unilateral vestibular dysfunction are the improvement in vestibulo-ocular reflex gain. And, for permanent unilateral vestibular dysfunction are reduction in catch-up saccades percentage, velocity, amplitude, latency, and Perez and Rey score.


Assuntos
Teste do Impulso da Cabeça , Vestíbulo do Labirinto , Humanos , Reflexo Vestíbulo-Ocular , Movimentos Sacádicos
12.
J Vis Exp ; (186)2022 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-35993707

RESUMO

Vestibular perceptual thresholds refer to the motion intensity required to enable a participant to detect or discriminate a motion based on vestibular input. Using passive motion profiles provided by six degree-of-motion platforms, vestibular perceptual thresholds can be estimated for any kind of motion and thereby target each of the sub-components of the vestibular end-organ. Assessments of vestibular thresholds are clinically relevant as they complement diagnostic tools such as caloric irrigation, the head impulse test (HIT), or vestibular evoked myogenic potentials (VEMPs), which only provide information on sub-components of the vestibular system, but none of them allow for assessing all components. There are several methods with different advantages and disadvantages for estimating vestibular perceptual thresholds. In this article, we present a protocol using an adaptive staircase algorithm and sinusoidal motion profiles for an efficient estimation procedure. Adaptive staircase algorithms consider the response history to determine the peak velocity of the next stimuli and are the most commonly used algorithms in the vestibular domain. We further discuss the impact of motion frequency on vestibular perceptual thresholds.


Assuntos
Potenciais Evocados Miogênicos Vestibulares , Vestíbulo do Labirinto , Teste do Impulso da Cabeça , Humanos , Movimento (Física) , Potenciais Evocados Miogênicos Vestibulares/fisiologia , Vestíbulo do Labirinto/fisiologia
14.
Otol Neurotol ; 43(9): e1029-e1033, 2022 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-36026605

RESUMO

OBJECTIVE: Gentamicin is a widely used aminoglycoside with ototoxicity as a known adverse effect. Because of the difficulty in clinical recognition, the prevalence of gentamicin ototoxicity in practice is thought to be higher than reported. This study aimed to prospectively assess the effect of gentamicin on vestibular function and whether ototoxicity is underrecognized. STUDY DESIGN: Single-center, prospective, nonblinded trial. SETTING: Inpatient tertiary hospital setting followed by vestibular outpatient clinic review. PATIENTS: Forty-eight patients undergoing a urologic procedure were recruited, with 24 and 17 patients having one or two follow-up tests, respectively, after initial gentamicin administration. INTERVENTIONS: Single dose of gentamicin during a urologic procedure. MAIN OUTCOME MEASURES: Gains for the vestibuloocular reflex (VOR) were measured using the video head impulse test before receiving gentamicin and at two other timepoints after gentamicin. The gains in VOR were then compared with previous testing sessions to determine if there was a deterioration after gentamicin use. RESULTS: Before receiving gentamicin, the gains for horizontal VOR were measured for 48 patients. The gains were measured a second time for 24 patients at varying durations postgentamicin (1-56 d) and a third time for 17 patients (14-152 d) postgentamicin. The mean VOR gain for Timepoints 1, 2, and 3 were 0.72 ± 0.13, 0.75 ± 0.16, and 0.79 ± 0.18, respectively. Linear-mixed model with repeated-measure analysis revealed no significant difference in VOR gain between Timepoints 1 and 2 ( p = 0.19). CONCLUSION: There was no significant effect observed on mean VOR gain decrement after a single dose of gentamicin.


Assuntos
Gentamicinas , Ototoxicidade , Aminoglicosídeos , Gentamicinas/efeitos adversos , Teste do Impulso da Cabeça , Humanos , Estudos Prospectivos , Reflexo Vestíbulo-Ocular
15.
Artigo em Chinês | MEDLINE | ID: mdl-36036064

RESUMO

Objective:To summarize gain characteristics of three pairs of semicircular canals in head impulse paradigm (HIMP) and suppression head impulse paradigm (SHIMP) in healthy young Chinese population. Methods:HIMP and SHIMP tests were performed on 40 healthy young volunteers enrolled as study group, by using EyeseeCam examiantion system (Interacoustics,Denmark). The elicitation rates and gain values of the two saccades were recorded, and the gain values were compared and analyzed. Results:The results of 40 healthy young people were as follows: in HIMP, the instantaneous gain at 60 ms of the horizontal semicircular canals were 1.11±0.07 on the left side and 1.08±0.07 on the right side; the regression gain of the horizontal semicircular canals were 1.09±0.06 on the left side and 1.10±0.06 on the right side; the regression gain of the vertical semicircular canals were 1.08±0.12 on the right anterior, 1.07±0.11 on the left posterior, 1.41±0.16 on the right posterior and 1.42±0.16 on the left anterior. So in HIMP, no significant difference could be found between left and right side in both horizontal and vertical semicircular canal conjugate plane regarding regression gain (P>0.05), except that 60 ms instantaneous gain on the left horizontal semicircular canals was slightly higher than that on the right side (P<0.05).The instantaneous gain values of the horizontal semicircular canal at 60 ms in SHIMP were 1.08±0.08 on the left side and 1.06±0.07 on the right side; the regression gain in horizontal semicircular canals were 1.06±0.07 on the left side and 1.07±0.06 on the right side, respectively; the regression gains of vertical semicircular canal were 1.06±0.13, 1.08±0.16, 1.49±0.16, 1.39±0.15, on the right anterior, left posterior, right posterior, and left anterior side. So in SHIMP, no significant difference could be found in 60 ms instantaneous gain in horizontal conjugate plane, regression gain in horizontal conjugate plane and regression gain in right anterior left posterior conjugate plane (P>0.05), while the regression gain of the left anterior right posterior conjugate plane in the right was found slightly higher than that of the left (P<0.05).Both 60 ms instantaneous gain and regression gain in horizontal conjugate plane in HIMP were slightly higher than that of SHIMP (P<0.05), while no significant difference could be found in vertical conjugate planes (P>0.05). In both HIMP and SHIMP tests, gains of the left anterior right posterior conjugate plane was slightly higher than that of both horizontal plane and the right anterior left posterior conjugate plane (P<0.05), while no significant difference could be found in gains between horizontal and the right anterior left posterior conjugate plane (P>0.05). Conclusion:Gain values of HIMP and SHIMP were slightly different among different semicircular canals conjugate planes.It is suggested that each examination center should establish normal values for their own and make correction regularly.


Assuntos
Teste do Impulso da Cabeça , Reflexo Vestíbulo-Ocular , Adolescente , China , Humanos , Movimentos Sacádicos , Canais Semicirculares
16.
Artigo em Chinês | MEDLINE | ID: mdl-36036066

RESUMO

Objective:To understand the occurrence of horizontal semicircular canal functional impairment in patients with common vestibular diseases and to explore the characteristics and clinical value of different evaluation methods of horizontal semicircular canal. Methods:From July 2013 to December 2016, patients who attended the vertigo clinic of the First Affiliated Hospital of Dalian Medical University and completed more than three horizontal semicircular canal function tests were retrospectively analyzed. A total of 396 patients diagnosed as vestibular migraine (VM), Ménière's disease (MD), benign paroxysmal positional vertigo (BPPV), vestibular neuritis (VN) and 104 patients with unknown diagnosis were enrolled. The results of caloric test (CT), rotation test (RT), head-shaking nystagmus test (HSN) and video head impulse test (vHIT) were collected and the abnormal detection rates of different detection methods were calculated. The sensitivity, specificity and coincidence rate of various detection methods were statistically analyzed using CT as the gold standard. Results:①The abnormal rates of the four evaluation methods from high to low were HSN, CT, RT, vHIT (51.20%, 50.80%, 25.76%, 19.74%, respectively); ②Taking CT as the gold standard, among these four common vestibular diseases, the sensitivity and specificity of vHIT were 0.13-0.41 and 0.69-1.00, the sensitivity and specificity of HSN were 0.44-0.76 and 0.29-0.69, and the sensitivity and specificity of RT were 0.25-0.45 and 0.50-0.84;③According to statistical analysis, only HSN and CT results showed no statistically significant difference in the 4 diseases. There was no significant difference between RT and CT in VM and BPPV, and vHIT and CT in BPPV. Conclusion:The abnormal rate of HSN results in common vestibular diseases is highest, and it could be recommended as a routine vestibular function screening item. The specificity of vHIT is highest and worthy of promotion. CT is still an irreplaceable method to evaluate the function of horizontal semicircular canal.


Assuntos
Transtornos de Enxaqueca , Doenças Vestibulares , Vertigem Posicional Paroxística Benigna , Teste do Impulso da Cabeça , Humanos , Estudos Retrospectivos , Canais Semicirculares
17.
Acta Otorhinolaryngol Ital ; 42(3): 281-286, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35880368

RESUMO

Objective: The aim of this study is to evaluate vestibular functions with video head impulse test (VHIT) and to understand the value of VHIT in differential diagnosis in patients with vestibular migraine (VM) during dizziness attack. Materials and methods: Two groups were enrolled in this study. The first consisted of 84 vestibular migraine patients, and second group of 74 healthy subjects. VHIT was applied to patients with VM during vertigo attack and the results were compared with the VHIT values applied to subjects in the control group. Results: The mean vestibulo-ocular reflex (VOR) in all semicircular canals in the VM group was lower than healthy individuals, but the results were not statistically significant. Refixation saccades were found in 52.3% of VM patients and in 10.2% of healthy individuals. Conclusions: When patients with VM were evaluated with VHIT during vertiginous attack, VOR gain values were not different from healthy individuals, but the number of catch-up saccades were higher in VM patients, which indicates peripheral vestibular involvement. For differential diagnosis in patients with VM, vestibular tests should be performed during the vertigo attack. When evaluating VHIT results, the presence of refixation saccades should also be evaluated.


Assuntos
Teste do Impulso da Cabeça , Transtornos de Enxaqueca , Teste do Impulso da Cabeça/métodos , Humanos , Transtornos de Enxaqueca/complicações , Transtornos de Enxaqueca/diagnóstico , Reflexo Vestíbulo-Ocular , Canais Semicirculares , Vertigem/diagnóstico , Vertigem/etiologia
18.
Artigo em Chinês | MEDLINE | ID: mdl-35725308

RESUMO

Objective: To analyze the characteristics of pulse-step-sine (PSS) test in healthy people of different ages and to discuss its clinical value. Methods: From July 10, 2018 to December 9, 2020, a total of 78 healthy volunteers, including 40 males and 38 females, were enrolled and divided into youth group, middle age group and old age group. The I Portal NOTC rotational-chair system (NKI) was applied for PSS detection to analyze the clinical characteristics of gain, phase, asymmetry, and slope of step and sinusoidal components. Statistical analysis was performed using SPSS17.0 software. Results: In the same age group, there were no statistically significant differences in left and right step gain, slope gain and sine gain (All P values were greater than 0.05). Pairwise comparison between different age groups showed that there was no significant difference in the corresponding parameters between the youth group and the middle age group. Compared with young group, the old age group had a significantly lower step gain value in their left side (P<0.01) but not in the right side (P>0.05).The left and right slopes of the old age group were significantly lower than those of the young group and the middle group, and the differences were statistically significant (All P values<0.05). Conclusion: The PSS test can detect bilateral and unilateral horizontal semicircular canal function with good tolerance in different age groups, better than the traditional rotational chair examination to determine the well-compensated unilateral vestibular function. PSS test is a new vestibular detection method.


Assuntos
Canais Semicirculares , Vestíbulo do Labirinto , Adolescente , Feminino , Teste do Impulso da Cabeça , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Reflexo Vestíbulo-Ocular
19.
Ear Hear ; 43(6): 1845-1852, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35696183

RESUMO

OBJECTIVE: Investigate the association between age-related hearing loss and reduced peripheral vestibular function using paired assessments of high-frequency hearing and horizontal semicircular canal (HSC) function. We hypothesized that age-related high-frequency hearing loss would be correlated with reduced HSC function and, therefore, useful to predict age-related vestibular hypofunction. DESIGN: We conducted a single center, retrospective cross-sectional study in a tertiary/academic referral hospital. This study included 185 patients who were diagnosed with a cerebellopontine angle (CPA) tumor and referred to the academic hospital to evaluate treatment options. Data collected included pure-tone audiometry, caloric reflex test, video head-impulse test (vHIT), and medical history. High-frequency hearing loss was quantified by the high Fletcher index (hFI), and horizontal semicircular canal (HSC) function were quantified by the caloric reflex test and vHIT. RESULTS: We observed a significant association between age and high-frequency hearing loss that was significantly worse in men compared with women. In contrast, we observed no significant association between age and HSC function assessed by either the caloric reflex test or vHIT. We observed associations between HSC function and sex, with male sex predicting reduced HSC function by caloric reflex testing but enhanced HSC function by vHIT. High-frequency hearing loss did not predict HSC hypofunction. CONCLUSIONS: We found no evidence indicating age-related decline in HSC function or an association between age-related high-frequency hearing loss and age-related decline in HSC function. We did observe sex-specific differences in HSC function. Our study highlights the need for sex-specific normative values for identifying age-related reduced peripheral vestibular function and for future work linking comprehensive assessments of inner ear function with tests of balance and stability to understand the complex interactions underlying hearing loss and imbalance, especially in the elderly.


Assuntos
Neuroma Acústico , Presbiacusia , Humanos , Masculino , Feminino , Idoso , Estudos Retrospectivos , Perda Auditiva de Alta Frequência , Estudos Transversais , Canais Semicirculares , Teste do Impulso da Cabeça , Testes Calóricos , Reflexo Vestíbulo-Ocular
20.
Int J Pediatr Otorhinolaryngol ; 158: 111170, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35537362

RESUMO

OBJECTIVES: This study aims to evaluate the effects of acquired esotropia on vestibulo-ocular reflex (VOR) gain in children using video (vHIT) and functional head impulse (fHIT) tests. METHODS: A total of 62 children aged 6-18 years, with acquired esotropia and normal vision, were evaluated in the study. The patients were divided into two sub-groups: accommodative and non-accommodative. VOR gains were analyzed by performing lateral canal vHIT and fHIT with monocular and binocular recordings by a single examiner. RESULTS: Seventeen (10 male, 7 female) children with accommodative esotropia, 24 (14 male, 10 female) children with non-accommodative esotropia, and 21 (8 male and 12 female) healthy controls were included in this study. The vHIT findings did not differ between the groups (p˃.05). In the non-accommodative esotropia group, the location of the camera in both binocular and monocular vHIT recordings made a significant difference in the left VOR gain (p = .025, z = -2.243, p = .032, and z = -2.143, respectively), but no difference was observed in the right VOR gain. In the accommodative esotropia group, while the camera was on the left there was a significant difference in the right VOR gain between binocular and monocular recordings (p = .016, z = -2.413) but no difference was observed in the left VOR gain. No overt or covert saccade was detected in any group. CONCLUSIONS: The statistical differences found in vHIT and fHIT in acquired esotropia patients are thought to be sporadic and based on the results of this study no correction or change in recording technique is required for vHIT or fHIT in children with acquired esotropia.


Assuntos
Esotropia , Doenças da Língua , Criança , Esotropia/diagnóstico , Feminino , Teste do Impulso da Cabeça/métodos , Humanos , Masculino , Reflexo Vestíbulo-Ocular , Movimentos Sacádicos , Canais Semicirculares
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