돌발성 난청환자에서 전정기능의 평가
Evaluation of Vestibular Function in Idiopathic Sudden Sensorineural Hearing Loss
2
조회
0
다운로드
2
인용
0
참고문헌
초록
Background and Objectives It is very important to evaluate vestibular function in patients with sudden sensorineural hearing loss (SNHL) because vertigo combined with sudden SNHL is well known as an important prognostic factor. However, the vestibular function test is not usually performed in sudden SNHL patients without vertigo. We investigated whether different vestibular function tests such as the results of vestibular evoked myogenic potential (VEMP) testing or caloric testing were correlated to prognosis in not only sudden SNHL patients with vertigo but also in sudden SNHL patients without vertigo. Subjects and Method We enrolled in our study 47 patients with idiopathic sudden SNHL with vertigo or without vertigo. The degree of initial hearing loss was categorized as mild, moderate, moderate-severe, severe, and profound group. Types of initial audiograms were categorized as high tone loss, low tone loss, flat and scale out type. We analyzed the association of the VEMP and caloric test with degree of hearing loss, type of audiogram, and hearing recovery in two month. Results The more sever the hearing loss was, the more increased was the rate of abnormal VEMP response (p=0.003). The rate VEMP and caloric abnormality was higher in hearing loss types with high tone loss than in the types with only low tone loss. The rate of accompanying vertigo was high (p=0.017), when the hearing loss was more severe. There was significant correlation between the hearing recovery and vestibular dysfunction (p=0.000, r=0.563). Conclusion VEMP and caloric test are useful in evaluating vestibular function and prognosis of sudden SNHL patients. Korean J Otorhinolaryngol-Head Neck Surg 2010;53:761-7
Abstract
Background and Objectives It is very important to evaluate vestibular function in patients with sudden sensorineural hearing loss (SNHL) because vertigo combined with sudden SNHL is well known as an important prognostic factor. However, the vestibular function test is not usually performed in sudden SNHL patients without vertigo. We investigated whether different vestibular function tests such as the results of vestibular evoked myogenic potential (VEMP) testing or caloric testing were correlated to prognosis in not only sudden SNHL patients with vertigo but also in sudden SNHL patients without vertigo. Subjects and Method We enrolled in our study 47 patients with idiopathic sudden SNHL with vertigo or without vertigo. The degree of initial hearing loss was categorized as mild, moderate, moderate-severe, severe, and profound group. Types of initial audiograms were categorized as high tone loss, low tone loss, flat and scale out type. We analyzed the association of the VEMP and caloric test with degree of hearing loss, type of audiogram, and hearing recovery in two month. Results The more sever the hearing loss was, the more increased was the rate of abnormal VEMP response (p=0.003). The rate VEMP and caloric abnormality was higher in hearing loss types with high tone loss than in the types with only low tone loss. The rate of accompanying vertigo was high (p=0.017), when the hearing loss was more severe. There was significant correlation between the hearing recovery and vestibular dysfunction (p=0.000, r=0.563). Conclusion VEMP and caloric test are useful in evaluating vestibular function and prognosis of sudden SNHL patients. Korean J Otorhinolaryngol-Head Neck Surg 2010;53:761-7
참고문헌 (18)
- Byl F, "Seventy-six cases of presumed sudden hearing loss occurring in 1973: prognosis and incidence", Laryngoscope, 87, pp.817~825 (1977)
- Mattox DE, "Natural history of sudden sensory neural hearing loss", Ann Otol Rhinol Laryngol, 86, pp.463~480 (1977)
- Laird N, "Predicting recovery from idiopathic sudden hearing loss", Am J Otolaryngol, 4(3), pp.161~164 (1983)
- Shaia FT, "Sudden sensorineural hearing impairment: a report of 1220 cases", Laryngoscope, 86(3), pp.389~398 (1976)
- Janky KL, "Vestibular Evoked Myogenic Potential (VEMP) Testing: normative Threshold Response Curves and Effects of Age", J Am Acad Audiol, 20(8), pp.514~522 (2009)
- Iwasaki S, "Extent of lesions in idiopathic sudden hearing loss with vertigo", Arch Otolaryngol Head Neck Surg, 131(10), pp.857~862 (2005)
- Murofushi T, "Abscent vestibular evoked myogenic potentials in vestibular neurolabyrinthitis", Arch Otolaryngol Head Neck Surg, 122(8), pp.845~848 (1996)
- Murofushi T, "Diagnostic value of prolonged latencies in the vestibular evoked myogenic potential", Arch Otolaryngol Head Neck Surg, 127(9), pp.1069~1072 (2001)
- Siegel LG, "The treatment of idiopathic sudden sensorineural hearing loss", Otolaryngol Clin North Am, 8(2), pp.467~473 (1975)
- Robertson DD, "Ireland DJ. Vestibular evoked myogenic potentials", J Otolaryngol, 24(1), pp.3~8 (1995)
- de Waele C, "Saccular dysfunction in Meniere’s disease", Am J Otol, 20(2), pp.223~232 (1999)
- Murofushi T, "Vestibular evoked myogenic potentials in patients with acoustic neuroma", Arch Otolaryngol Head Neck Surg, 124(5), pp.509~512 (1998)
- Hong SM, "Saccular damage in patients with idiopathic sudden sensorineural hearing loss without vertigo", Otolaryngology Head Neck Surg, 139(4), pp.541~545 (2008)
- 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)
- Nakashima T, "Outcome of sudden deafness with and without vertigo", Laryngoscope, 103(10), pp.1145~1149 (1993)
- Fujikawa S, "Vestibular neuropathy accompanying auditory and peripheral neuropathies", Arch Otolaryngol Head Neck Surg, 126(12), pp.1453~1456 (2000)
- Khetarpal U, "Investigation into the causes of vertigo in sudden sennsorineural hearing loss", Otolaryngol Head Neck Surg, 105(3), pp.360~371 (1991)