Cervical vestibular evoked myogenic potentials and video head impulse test in Ménière disease

Abstract Introduction: Ménière's disease is among the most frequent causes of vestibular disorders. Although it is a clinical diagnosis, a better understanding of the pathophysiology and clinical course of the disease through tests would allow improvement in the prognosis and more effective treatments. Objectives: To describe the results of the cervical vestibular evoked myogenic and video head impulse test in patients with a defined diagnosis of Ménière's disease and to correlate them with disease duration. Methods: The sample consisted of 50 participants, of whom 29 comprised the study group and 21 the control group. The individuals were submitted to a questionnaire, otoscopy, audiometry and vestibular function assessment through the cervical vestibular evoked myogenic potential and video head impulse test. Results: For the video head impulse test, lateral canal gain values below 0.77 were considered abnormal and for the vertical channels, below 0.61. The percentages of normality were 82.76% for lateral, 89.65% for posterior and 91.37% for anterior canals. For the cervical vestibular evoked myogenic potential, the upper limits of normal for latencies were defined as 18.07 ms for p13 and 28.47 ms for n23; and in the SG, 19.57% showed prolongation of latency of p13 and 4.35% of wave n23, whereas 18.96% did not show biphasic potential. Conclusions: For the video head impulse test, a decreased gain of the vestibulo-ocular reflex for the lateral canal was observed, with a higher incidence of overt type corrective saccades compared to the control group. For the cervical vestibular evoked myogenic potential, there was a significant difference between the groups for the inter-amplitude parameter, including for asymptomatic ears. There was no correlation between the results of the tests and disease duration.摘要：梅尼埃病（Ménière's disease）是最常见的前庭功能障碍病因之一。尽管该病属于临床诊断范畴，但通过检测手段进一步明晰其病理生理学机制与临床病程，将有助于改善患者预后并制定更高效的治疗方案。 研究目的：明确确诊梅尼埃病患者的颈性前庭诱发肌源性电位（cervical vestibular evoked myogenic）与视频头脉冲试验（video head impulse test）检测结果，并分析其与病程时长的相关性。 研究方法：本研究共纳入50名受试者，其中研究组29例，对照组21例。所有受试者均接受问卷调查、耳镜检查、听力学检测，以及通过颈性前庭诱发肌源性电位与视频头脉冲试验开展的前庭功能评估。 研究结果：视频头脉冲试验中，半规管增益值异常判定标准为：水平半规管增益＜0.77，垂直半规管增益＜0.61。各半规管的正常检出率分别为：水平半规管82.76%、后半规管89.65%、前半规管91.37%。颈性前庭诱发肌源性电位的正常潜伏期上限为：p13波18.07ms，n23波28.47ms；研究组中19.57%的受试者存在p13波潜伏期延长，4.35%存在n23波潜伏期延长，另有18.96%未检出双相电位。 研究结论：视频头脉冲试验显示，梅尼埃病患者的水平半规管前庭眼反射（vestibulo-ocular reflex）增益降低，且显性矫正扫视的发生率显著高于对照组。颈性前庭诱发肌源性电位的波幅间参数在两组间存在显著差异，即便对于无症状耳部亦是如此。本次检测结果与患者病程时长未呈现显著相关性。