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Comprehensive Analysis of Vestibular Evoked Myogenic Potential, Video Head Impulse, and Posturography and Their Symptomatic Correlation in Patients with Acute Vestibular Neuritis
Dept. of Otolaryngology, Asan Medical Center, Univ. of Ulsan College of Medicine©ö, Dept. of Otolaryngology-Head and Neck Surgery, Korea Univ. Ansan Hosp.©÷
Shin-Ae KIM, Shin-Ae KIM1, Myung Hoon YOO2, Je Yeon LEE1, Joong Ho AHN1, Jong Woo CHUNG1, Tae Hyun YOON1, Hong Ju PARK1
¸ñÀû: Cervical and ocular VEMP (cVEMP and oVEMP) represent saccular and utricular function. Video head impulse test (vHIT) probe canal function in all 3 planes and posturography examine the postural stability. The aims of this study were to evaluate results of vestibular tests with symptomatic correlation and classify the involvement patterns of SCC and otolith organs in acute unilateral vestibular neuritis (VN). ¹æ¹ý:Fifty-one patients (36 male, 15 female) diagnosed as acute vestibular neuritis based on caloric test (canal paresis 20%) were included. We analyzed caloric, vHIT, oVEMP, cVEMP, sensory organization test (SOT) and dizziness handicap index (DHI) at initial presentation. Abnormal vHIT was evaluated by mean vestibulo-ocular reflex gains, gain asymmetry, re-fixation saccades. °á°ú:Twenty-nine patients (56.9%) showed abnormal oVEMP, and 8 (15.7%) showed abnormal cVEMP results. Patients with abnormal oVEMP had significantly lower LSCC gain, lower PSCC gain, higher LSCC GA, higher canal paresis (p=0.001, p=0.027, p=0.024, p=0.006, respectively) when compared with patients with normal oVEMP. Abnormal cVEMP patients showed significantly lower LSCC gain when compared with patients with normal cVEMP (p=0.037). Composite score of SOT was significantly correlated with LSCC Gain, PSCC Gain, LSCC GA, SSCC GA, canal paresis and DHI total score. DHI total score was significantly correlated with PSCC gain and composite score. Forty-one patients (80.4%) showed pan-vestibular neuritis, 8 patients (15.7%) showed superior VN, 1 patient (2%) isolated LSCC VN, and 1 patient showed no abnormality in both VEMP and vHIT. °á·Ð:Our findings suggest that VN patients with abnormal oVEMP or cVEMP results showed worse canal functions in vHIT, and the results of SOT, and vHIT showed significant relationship with the degree of symptom. When performing comprehensive vestibular tests, most patients with acute VN showed involvement of superior and inferior vestibular nerve.


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