大前庭水管综合征前庭功能及听力学相关检查的研究与分析

发布时间：2018-05-19 02:05

本文选题：大前庭水管综合征 + 前庭诱发的肌源性电位　；参考：《福建医科大学》2011年硕士论文

【摘要】：目的通过记录、分析大前庭水管综合征(LVAS)患者前庭诱发的肌源性电位(VEMP)、主观垂直视觉检查(SVV)、冷热试验和纯音测听(PTA),了解LVAS患者的球囊、椭圆囊、前庭功能(主要是水平半规管功能)及其传导通路的功能状况以及与听力学特点的关系。方法分别对22例(42患耳)LVAS患者组和20例正常组行VEMP、SVV、冷热试验及纯音测听等检查,结合临床症状比较分析其检查结果。所得结果用SPSS13.0统计软件进行统计学分析。结果 LVAS患者组42患耳中25耳(占59.5%)VEMP表现为高振幅和(或)低阈值。在LVAS患者组中VEMP低阈值组前庭水管内径平均值为(4.30±0.53)mm,其中19耳主观听力较易受外界原因或发热致颅内压增高的改变而波动。42患耳纯音测听有30耳(占71.4%)表现为低中频(2KHz以下)存在明显气骨导差的混合性聋。LVAS患者组与正常组VEMP检查的P13、N23平均潜伏期无显著差异(P0.05),而两组患者VEMP平均振幅及平均阈值存在明显差异(P0.01); LVAS患者组与正常组SVV检查及冷热试验检查无统计学意义(P0.05)。结论 1、大多LVAS患者前庭诱发的肌源性电位(VEMP)表现为高振幅和(或)低阈值,其纯音测听(PTA)表现为低中频存在明显气骨导差的混合性聋。这可能与“第三窗”的存在有关。 2、在LVAS患者中,VEMP阈值较低者,其前庭水管平均内径值较大,主观听力也易受外界原因或发热致颅内压增高的改变而波动。而纯音听力损失程度跟前庭水管内径平均值无相关性,与VEMP振幅的大小及阈值的高低亦无相关性。 3、LVAS患者组VEMP检查结果与正常组存在显著差异,而冷热试验及SVV检查结果与正常组无明显差异。从而推测变异的大前庭水管可能只是使球囊的功能受到影响,而对椭圆囊功能和前庭功能(主要是水平半规管功能)无明显影响。
[Abstract]:Purpose By recording and analyzing vestibular evoked myogenic potentials (VEMPV), subjective vertical visual examination (VVV), cold and hot test and pure tone audiometry (PTAA) in patients with large vestibular aqueduct syndrome (LVASS), we studied the balloon and elliptical sac of patients with LVAS. The functional status of vestibular function (mainly horizontal semicircular canal) and its conduction pathway and its relationship with audiological characteristics. Method VEMPV SVV, cold and hot test and pure tone audiometry were performed in 22 patients with LVAS of 42 ears and 20 normal subjects. The results were compared with clinical symptoms. The results were analyzed by SPSS13.0 software. Result In the LVAS group, 25 of 42 affected ears showed high amplitude and / or low threshold value (59.5%)VEMP). In the LVAS group, the average vestibular aqueduct diameter in the VEMP low threshold group was 4.30 卤0.53 mm, of which 19 ears were more susceptible to fluctuations due to external causes or increased intracranial pressure due to fever. There was no significant difference in the average latency of P13 N23 between the patients with LVAS and the normal group, but there was a significant difference in the mean amplitude and threshold of VEMP between the two groups (P 0.01). There was no significant difference between SVV and cold and hot test in normal group (P 0.05). Conclusion 1. The vestibular evoked myogenic potential (VEMPP) in most LVAS patients showed high amplitude and / or low threshold, and the pure tone audiometry showed mixed deafness with obvious air-bone conductance difference at low intermediate frequency. This may have something to do with the existence of the third window. 2. In LVAS patients with lower threshold value, the vestibular aqueduct average diameter was larger, and subjective hearing was easily fluctuated by the change of intracranial pressure caused by external causes or fever. However, there was no correlation between pure tone hearing loss and the average diameter of vestibular aqueduct, nor with the amplitude and threshold of VEMP. 3There was significant difference between VEMP and normal group, but there was no significant difference in cold and hot test and SVV between the two groups. It is speculated that the large vestibular aqueduct may only affect the function of the balloon, but not the function of the elliptical sac and vestibular vestibule (mainly the horizontal semicircular canal).
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R764.3

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