上半规管开裂时颅骨振动引起的眼震:前庭探查的新视角--综述

IF 2.1 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY
G. Dumas, Ian Curthoys, A. Castellucci, Laurent Dumas, Laetitia Peultier-Celli, Enrico Armato, Pasquale Malara, P. Perrin, S. Schmerber
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引用次数: 0

摘要

第三视窗综合征通常与图利奥现象有关,目前最常见于上半圆孔开裂(SCD)患者,但并非这种病变所特有。提示这种病变的临床和前庭测试并不总是同时出现,最近又出现了颅骨振动诱发的眼球震颤测试,这构成了骨传导图利奥现象(BCTP)。这项工作旨在从文献中收集通过骨传导刺激对 SCD 进行床旁测试所得出的见解。研究采用了PRISMA指南,纳入并分析了10篇文献。在 55% 到 100% 的 SCD 患者中观察到的颅骨振动诱发的眼球震颤(SVIN)通常是 SCD 的信号,其灵敏度高于气导图利奥现象(ACTP)或亨内伯特征。以 100 Hz 频率在顶点位置进行测试时,SVIN 的方向通常是同侧跳动,82% 的病例中水平和扭转成分为同侧跳动,垂直成分为向下跳动。在 100 赫兹频率下,顶点刺激比乳突刺激更有效,但在更高频率下,两者效果相当。SVIN 的效率可能取决于刺激的位置、顺序和持续时间。在 SCD 中,SVIN 频率敏感性向高频扩展,400 Hz 左右为最佳。SVIN 的方向 25% 取决于刺激频率,50% 取决于刺激位置。乳突刺激在刺激侧后经常出现不同的结果。在 25% 的病例中观察到的后震颤可根据最近的生理学数据进行解释,这些数据显示了两种激活模式:(1)SCC 传入器中不规则静息放电的动作电位的逐周期锁相激活;(2)由声音或振动在开裂点引发的液体位移游走波造成的杯状流体偏转。SVIN 的方向和强度可能是这两种机制竞争的结果。这种不稳定性解释了在某些患者身上观察到的 SVIN 随刺激位置和频率的变化而变化,也解释了研究者之间的差异。在临床实践中,SVIN 是诊断 SCD 的其他床旁检查方法中最新的有用方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Skull Vibration-Induced Nystagmus in Superior Semicircular Canal Dehiscence: A New Insight into Vestibular Exploration—A Review
The third window syndrome, often associated with the Tullio phenomenon, is currently most often observed in patients with a superior semicircular-canal dehiscence (SCD) but is not specific to this pathology. Clinical and vestibular tests suggestive of this pathology are not always concomitantly observed and have been recently complemented by the skull-vibration-induced nystagmus test, which constitutes a bone-conducted Tullio phenomenon (BCTP). The aim of this work was to collect from the literature the insights given by this bedside test performed with bone-conducted stimulations in SCD. The PRISMA guidelines were used, and 10 publications were included and analyzed. Skull vibration-induced nystagmus (SVIN), as observed in 55 to 100% of SCD patients, usually signals SCD with greater sensitivity than the air-conducted Tullio phenomenon (ACTP) or the Hennebert sign. The SVIN direction when the test is performed on the vertex location at 100 Hz is most often ipsilaterally beating in 82% of cases for the horizontal and torsional components and down-beating for the vertical component. Vertex stimulations are more efficient than mastoid stimulations at 100 Hz but are equivalent at higher frequencies. SVIN efficiency may depend on stimulus location, order, and duration. In SCD, SVIN frequency sensitivity is extended toward high frequencies, with around 400 Hz being optimal. SVIN direction may depend in 25% on stimulus frequency and in 50% on stimulus location. Mastoid stimulations show frequently diverging results following the side of stimulation. An after-nystagmus observed in 25% of cases can be interpreted in light of recent physiological data showing two modes of activation: (1) cycle-by-cycle phase-locked activation of action potentials in SCC afferents with irregular resting discharge; (2) cupula deflection by fluid streaming caused by the travelling waves of fluid displacement initiated by sound or vibration at the point of the dehiscence. The SVIN direction and intensity may result from these two mechanisms’ competition. This instability explains the SVIN variability following stimulus location and frequency observed in some patients but also discrepancies between investigators. SVIN is a recent useful insight among other bedside examination tests for the diagnosis of SCD in clinical practice.
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来源期刊
Audiology Research
Audiology Research AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY-
CiteScore
2.30
自引率
23.50%
发文量
56
审稿时长
11 weeks
期刊介绍: The mission of Audiology Research is to publish contemporary, ethical, clinically relevant scientific researches related to the basic science and clinical aspects of the auditory and vestibular system and diseases of the ear that can be used by clinicians, scientists and specialists to improve understanding and treatment of patients with audiological and neurotological disorders.
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