Retro-labyrinthine Lesion Site Detected by Galvanic Vestibular Stimulation Elicited Vestibular-evoked Myogenic Potentials in Patients with Auditory Neuropathy

• 作者: Zi-chen CHEN Yu-zhong ZHANG Huan-di ZHAO Xinyu WEI Toshihisa Murofushi Juan HU Ying CHENG Fei-yun CHEN Xin-da XU Min XU Qing ZHANG
• 来源期刊: 当代医学科学（英文）
• 年，卷（期）: 2021,（4）
• 所属期刊栏目: VERTIGO AND HEARING COLUMN
• 页码范围: 695-704
• 页数: 10页
• 语种: 英文
• DOI: 10.1007/s11596-021-2411-5

摘要

Objective:Auditory neuropathy(AN)is a unique pattern of hearing loss with preservation of hair cell function.The condition is characterized by the presence of otoacoustic emissions(OAE)or cochlear microphonic(CM)responses with severe abnormalities of the auditory brainstem response(ABR).The vestibular branches of the Ⅷ cranial nerve and the structures innervated by it can also be affected.However,the precise lesion sites in the vestibular system are not well characterized in patients with AN.Methods:The air-conducted sound(ACS)vestibular-evoked myogenic potentials(VEMPs)and galvanic vestibular stimuli(GVS)-VEMPs were examined in 14 patients with AN.Results:On examination of VEMPs(n=14,28 ears),the absent rates of ACS-cervical VEMP(cVEMP),ACS-ocular VEMP(oVEMP),GVS-cVEMP,GVS-oVEMP and caloric test were 92.9％(26/28),85.7％(24/28),67.9％(19/28),53.6％(15/28),and 61.5％(8/13),respectively.Impaired functions of the saccule,inferior vestibular nerve,utricle,superior vestibular nerve,and horizontal semicircular canal were found in 25.0％(7/28),67.9％(19/28),32.1％(9/28),53.6％(15/28)and 61.5％(8/13)patients,respectively.On comparing the elicited VEMPs parameters of AN patients with those of normal controls,both ACS-VEMPs and GVS-VEMPs showed abnormal results in AN patients(such as,lower presence rates,elevated thresholds,prolonged latencies,and decreased amplitudes).Conclusion:The study suggested that patients with AN often have concomitant vestibular disorders.Retro-labyrinthine lesions were more frequently observed in this study.GVS-VEMPs combined with ACS-VEMPs may help identify the lesion sites and facilitate detection of areas of vestibular dysfunction in these patients.