잠재적 전정기능 장애를 동반한 돌발성 난청 환자에서 전정기능검사의 역할
The Role of Vestibular Function Tests in Patients with Sudden Sensorineural Hearing Loss Who Have Subclinical Vestibular Dysfunction
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Background and Objectives The evaluation of vestibular function is very important for patients with sudden sensorineural hearing loss (SNHL) as it is a well-known prognostic factor. The purpose of this study was to evaluate subclinical vestibular dysfunction (SVD) and its association with prognosis in sudden SNHL patients with and without dizziness using the vestibular function tests. Subjects and Method Seventy eight patients who had been diagnosed with unilateral sudden SNHL were examined by dividing them into three groups according to their clinical findings such as vestibular function and subjective symptoms: 1) normal, 2) SVD and 3) dizziness. Vestibular dysfunction and hearing recovery rates were also assessed. Results Patients with SVD accounted for 62.5% of patients even though they did not complain subjective dizziness. The extent of vestibular dysfunction in the dizziness group was greater than that in the SVD group (p=0.05). The hearing recovery rates for normal, SVD and dizziness group were 72% (13/18), 57% (17/30) and 48% (12/25), respectively. The incidence and extent of vestibular dysfunction was greater in patients with severe hearing loss than in those with moderate to severe loss. A significant correlation was noted between hearing recovery rate and vestibular evoked myogenic potential (VEMP) testing. Normal and abnormal VEMP data were associated with good and poor recovery (p=0.001). Conclusion The evaluation of vestibular function is important in sudden SNHL patients with dizziness; however, SVD also explains a significant proportion of sudden SNHL in the absence of dizziness. Notably, VEMP is useful tools for evaluating prognosis of sudden SNHL.
Abstract
Background and Objectives The evaluation of vestibular function is very important for patients with sudden sensorineural hearing loss (SNHL) as it is a well-known prognostic factor. The purpose of this study was to evaluate subclinical vestibular dysfunction (SVD) and its association with prognosis in sudden SNHL patients with and without dizziness using the vestibular function tests. Subjects and Method Seventy eight patients who had been diagnosed with unilateral sudden SNHL were examined by dividing them into three groups according to their clinical findings such as vestibular function and subjective symptoms: 1) normal, 2) SVD and 3) dizziness. Vestibular dysfunction and hearing recovery rates were also assessed. Results Patients with SVD accounted for 62.5% of patients even though they did not complain subjective dizziness. The extent of vestibular dysfunction in the dizziness group was greater than that in the SVD group (p=0.05). The hearing recovery rates for normal, SVD and dizziness group were 72% (13/18), 57% (17/30) and 48% (12/25), respectively. The incidence and extent of vestibular dysfunction was greater in patients with severe hearing loss than in those with moderate to severe loss. A significant correlation was noted between hearing recovery rate and vestibular evoked myogenic potential (VEMP) testing. Normal and abnormal VEMP data were associated with good and poor recovery (p=0.001). Conclusion The evaluation of vestibular function is important in sudden SNHL patients with dizziness; however, SVD also explains a significant proportion of sudden SNHL in the absence of dizziness. Notably, VEMP is useful tools for evaluating prognosis of sudden SNHL.
참고문헌 (14)
- Byl FM, "Seventy-six cases of presumed sudden hearing loss occurring in 1973: prognosis and incidence", Laryngoscope, 87(5 Pt 1), pp.817~825 (1977)
- Mattox DE, "Natural history of sudden sensorineural hearing loss", Ann Otol Rhinol Laryngol, 86(4 Pt 1), pp.463~480 (1977)
- Kwon TH, "Combined therapy for sudden sensorineural hearing loss", Korean J Otolaryngol, 38(8), pp.1183~1188 (1995)
- Lim HS, "A clinical analysis of idiopathic sudden sensorineural hearing loss", Korean J Otolaryngol, 29(2), pp.191~200 (1986)
- Nakashima T, "Outcome of sudden deafness with and without vertigo", Laryngoscope, 103(10), pp.1145~1149 (1993)
- Byl FM Jr, "Sudden hearing loss: eight years’ experience and suggested prognostic table", Laryngoscope, 94(5 Pt 1), pp.647~661 (1984)
- Shaia FT, "Sudden sensori-neural hearing impairment: a report of 1,220 cases", Laryngoscope, 86(3), pp.389~398 (1976)
- Wilson WR, "The efficacy of steroids in the treatment of idiopathic sudden hearing loss. A double-blind clinical study", Arch Otolaryngol, 106(12), pp.772~776 (1980)
- Siegel LG, "The treatment of idiopathic sudden sensorineural hearing loss", Otolaryngol Clin North Am, 8(2), pp.467~473 (1975)
- Laird N, "Predicting recovery from idiopathic sudden hearing loss", Am J Otolaryngol, 4(3), pp.161~164 (1983)
- Robertson DD, "Vestibular evoked myogenic potentials", J Otolaryngol, 24(1), pp.3~8 (1995)
- Golz A, "The effects of noise on the vestibular system", Am J Otolaryngol, 22(3), pp.190~196 (2001)
- Perez R, "Vestibular and cochlear ototoxicity of topical antiseptics assessed by evoked potentials", Laryngoscope, 110(9), pp.1522~1527 (2000)
- Fujikawa S, "Vestibular neuropathy accompanying auditory and peripheral neuropathies", Arch Otolaryngol Head Neck Surg, 126(12), pp.1453~1456 (2000)