Objective:To establish the normal values of subjective visual vertical （SVV） in different head deflection angles and analyze its test and retest reliability, in order to provide a reference for the clinical application of SVV in the evaluation of vestibular disorders. Methods:Thirty-one healthy young people were selected to wear VR glasses, and the SVV data were tested in five different head-tilt, namely, 0° in the upright head position, 45°in the left head position, 45° in the right head position, 90° in the left head position, and 90° in the right head position, and were re-tested 2 weeks later. Results:①The mean values of SVV at 5 different head-tilt angles of 0°, left 45°, right 45°, left 90°, and right 90° were -0.07±1.71, 4.30±5.39, -6.51±5.58, -3.76±7.42, and 0.40±8.02, respectively, The 95% confidence limits of SVV at 0°, left 45°, right 45°, left 90°, right 90°, and right 90° were （-3.42, 3.28）, （-6.26, 14.86）, （-17.45, 4.43）, （-18.30, 10.78）, and（-15.32, 16.12）, respectively; ②The absolute values of SVV at 4 different head-tilt angles of left 45°, right 45°, left 90°, and right 90° were 5.62±3.96, 6.90±5.07, 6.82±4.70 and 6.48±4.68, respectively. The 95% confidence limits of SVV at left 45°, right 45°, left 90°, right 90°, and right 90° were（0，12.11）,（0，15.21）,（0，14.53）and（0，14.16）, respectively. The asymmetry ratio is 10% for the absolute value of the 45 ° deviation and 3% for the absolute value of the 90° deviation; ③Intra-class correlation coefficients（ICC） for 0°, left 45°, right 45°, left 90°, right 90°were 0.757, 0.673, 0.674, 0.815, and 0.856, respectively. Conclusion:SVV has good retest reliability and high stability, and the SVV normal value data of different head deviation angles established in the present study can be used as a reference for the diagnosis and evaluation of vestibular disorders.

目的 构建听力正常婴幼儿不同频率短纯音听性脑干反应(TB-ABR)波V强度-潜伏期函数曲线,为临床TB-ABR反应阈的判断提供参考.方法 选取40例(80耳)听力正常婴幼儿作为研究对象,月龄3～12月,平均7.2±2.8月.分别选取 70、60、50、40、30 dB nHL 5 个不同刺激强度进行 TB-500、TB-1 000、TB-2 000和 TB-4 000 Hz 4个频率的TB-ABR检测,记录不同强度下各频率的波V潜伏期,使用SPSS 26.0进行统计学分析,建立各频率不同强度下的强度-潜伏期函数模型.结果 ①同一强度不同频率下的波V潜伏期差异均有统计学意义(P＜0.05);②阈值强度下不同频率下的波V潜伏期差异均有统计学意义(P＜0.05);③同一频率不同强度波V潜伏期差异均有统计学意义(P＜0.05);④不同刺激频率下的强度-潜伏期函数模型分别为TB-500 Hz:y=-0.09x+16.59;TB-1 000 Hz:y=-0.07x+13.73;TB-2 000 Hz:y=-0.05x+10.61;TB-4 000 Hz:y=-0.04x+9.44.结论 TB-ABR的波V潜伏期随刺激声频率和/或强度的升高而逐渐缩短,本研究建立的不同频率不同强度下的TB-ABR强度-潜伏期函数模型可为本实验室临床提供参考.

Objective: To investigate the associations between cognition, anxiety, depression, and residual dizziness after successful repositioning maneuvers in the elderly with benign paroxysmal positional vertigo (BPPV). Methods: We enrolled 40 elderly patients with BPPV in our outpatient department. We used the Dizziness Handicap Inventory (DHI), Visual Analog Scale (VAS), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder Questionnaire-7 (GAD-7) to assess the degree of dizziness, anxiety, and depression of participants before repositioning therapy, respectively. At the 1-week follow-up after BPPV treatment, each participant will be reassessed and divided into a group with residual dizziness (RD) and a group without residual dizziness (NRD) based on the follow-up DHI score. The Mini-Mental State Examination (MMSE) evaluated the cognitive function of the participants. Results: The age, gender, duration of BPPV, and involved semicircular canals in the two groups did not show a significant difference. The RD group scored significantly higher on the DHI (p = 0.006), GAD-7 (p < 0.001), and PHQ-9 (p = 0.002) before the repositioning treatment than the NRD group. The two groups had no significant difference in MMSE score (p = 0.381). Anxiety and depression scores before repositioning treatment significantly and positively correlated with follow-up DHI scores (r = 0.678 and 0.522, respectively), but the MMSE score did not significantly relate to it. The univariate linear regression showed that the DHI (p < 0.001), GAD-7 (p < 0.001), and PHQ-9 (p = 0.002) scores before treatment could predict residual dizziness. The multivariate linear regression showed that GAD-7 before treatment was the only significant predictor of residual dizziness (p < 0.001). Conclusion: The level of dizziness, anxiety, and depression before treatment can predict residual dizziness after successful repositioning maneuvers in the elderly with BPPV. Anxiety may be the strongest predictor of residual dizziness after successful repositioning treatment in elderly BPPV patients.

OBJECTIVE:Our aim was to determine the correlation between cognitive impairment and P300 event-related potential (ERP) in older adults with vertigo and imbalance, which further provides a reference for clinical diagnosis and patients' rehabilitation.METHODS:A total of 79 older adult patients with vertigo and imbalance in our outpatient department from January 2022 to December 2022 were selected and divided into the mild group (n = 20), moderate group (n = 39), and severe group (n = 20) according to the Dizziness Handicap Inventory (DHI). The auditory P300 component of event-related potentials (ERPs), Generalized Anxiety Disorder Questionnaire-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Mini-Mental State Examination (MMSE) were used to evaluate depression, anxiety, and cognitive function in these patients, respectively.RESULTS:The P300 latencies of the different severity groups were 292 ± 10 ms, 301 ± 8 ms, and 328 ± 5 ms, respectively, and the differences were statistically significant (p = 0.010). The P300 amplitudes of the different severity groups were 14.4 ± 2.6 μV, 3.9 ± 0.8 μV, and 5.1 ± 1.4 μV, respectively, and the differences were also statistically significant (p = 0.004). There was no statistically significant difference in the DHI evaluation or VAS visual simulation scoring between the two groups (p = 0.625, and 0.878, respectively). Compared with the short-course group, the long-course group showed prolonged P300 latency and decreased amplitude, higher scores in PHQ-9 and GAD-7, and lower scores in MMSE, and all the differences were statistically significant (p = 0.013, 0.021, 0.006, 0.004, and 0.018, respectively).CONCLUSION:Older patients with more severe symptoms of vertigo and imbalance are at higher risk of developing abnormal cognitive function. The P300 can be used as an objective neurophysiological test for the assessment of cognitive function relevant to elderly patients with vertigo and imbalance.

BackgroundThe cause of idiopathic sudden sensorineural hearing loss (ISSNHL) remains unknown. It has been found that the functional status of the vestibular otolith is relevant to its prognosis; however, the evaluation of the vestibular otolith (intra-labyrinth) and superior and inferior vestibular nerve pathways (retro-labyrinth) in ISSNHL patients is not well-documented.ObjectiveThis study aimed to investigate the functional status of the vestibular otolith and conductive pathway in patients with unilateral ISSNHL and analyze the correlations between vestibular evoked myogenic potentials (VEMPs) and hearing improvement after treatment.MethodsA total of 50 patients with unilateral ISSNHL underwent a battery of audio-vestibular evaluations, including pure tone audiometry, middle ear function, air-conducted sound-cervical VEMP (ACS-cVEMP), ACS-ocular VEMP (ACS-oVEMP), galvanic vestibular stimulation-cervical VEMP (GVS-cVEMP), and GVS-ocular VEMP (GVS-oVEMP). The results of auditory and VEMPs were retrospectively analyzed.ResultsThe abnormal rates of ACS-cVEMP, ACS-oVEMP, GVS-cVEMP, and GVS-oVEMP in affected ears were 30, 52, 8, and 16%, respectively. In affected ears, the abnormal rate of ACS-oVEMP was significantly higher than that of ACS-cVEMP (p = 0.025), while it was similar between GVS-cVEMP and GVS-oVEMP (p = 0.218). Compared with GVS-cVEMP, affected ears presented with a significantly higher abnormal rate of ACS-cVEMP (p = 0.005), and the abnormal rate of ACS-oVEMP was significantly higher than that of GVS-oVEMP (p < 0.001). No significant difference existed in latency and amplitude between affected and unaffected ears in ACS-VEMPs or GVS-VEMPs (p > 0.05). The abnormal rate of VEMPs in the poor recovery group was significantly higher than that of the good recovery group (p = 0.040). The abnormality percentages of ACS-oVEMP and GVS-oVEMP in the poor recovery group were significantly higher than that of the good recovery group (p = 0.004 and 0.039, respectively). The good hearing recovery rates were 76.47% in the normal VEMPs group, 58.33% in the intra-labyrinth lesion group, and 22.22% in the retro-labyrinth lesion group. Hearing recovery worsened as a greater number of abnormal VEMPs was presented.ConclusionBesides Corti's organ, the impairment of otolithic organs was prominent in patients with ISSNHL. The normal VEMPs group had the highest rate of good recovery, followed by the intra-labyrinth lesion group and the retro-labyrinth lesion group presented with the lowest recovery rate. Abnormalities in ACS-oVEMP and/or GVS-oVEMP were indicators of a poor prognosis.

Objective:This study was to retrospectively analyze the results of vestibular-evoked myogenic potentials（VEMP） in unilateral Meniere's disease（MD） patients. Methods:The clinical assessment results of MD patients who visited the department between January 2016 to February 2022 were reviewed. Unilateral MD patients who met the inclusion and exclusion criteria were divided into three groups according to clinical stages, namely, group 1（stage Ⅰ+ stage Ⅱ）, group 2（stage Ⅲ） and group 3（stage Ⅳ）. The normal value data were used to investigate the incidence of abnormal P1 and N1 latencies, abnormal P1-N1 interwave latency, and abnormal interaural amplitude asymmetry ratio（IAR）. Afterwards, considering all the above mentioned parameters, the VEMP result of each patient was graded into four levels（grade 1 means VEMP result is normal, grade 2, 3 and 4 means the VEMP result is abnormal in different degrees）. The correlation between VEMP result level and pure tone average（PTA） of MD patients in different clinical stages was examined. Results:The prevalence of cVEMP in three groups was 84.2%, 70.0% and 33.3%, respectively（P<0.05）. The prevalence of oVEMP in three groups was 63.2%, 34.0% and 16.7%, respectively（P<0.05）. The incidence of abnormal P1 latency, N1 letancy and P1-N1 interwave latency of cVEMP was 21.1%, 26.3% and 24.6%, respectively. The incidence of abnormal P1 latency, N1 latency and interwave latency of oVEMP was 15.6%, 43.8% and 3.1%, respectively. The incidence of abnormal cVEMP IAR in group 1, group 2 and group 3 was 6.7%, 21.2% and 33.3%, respectively（P>0.05）. The incidence of abnormal IAR of oVEMP in group 1, group 2 and group 3 was 16.7%, 23.1% and 0, respectively（P>0.05）. cVEMP and oVEMP result levels were significantly correlated with PTA（r=0.339, P<0.01; r=0.362, P<0.01 ）, respectively. Conclusion:With the progression of MD, the function of saccule-vestibular inferior nerve pathway and utricle-vestibular superior nerve pathway would deteriorate in the same way as hearing.

ObjectiveWe compared the characteristics of air-conducted sound cervical vestibular evoked myogenic potential (ACS-cVEMP) and bone-conducted vibration cVEMP (BCV-cVEMP) among 3-month-old infants with normal hearing and sensorineural hearing loss (SNHL), and healthy adults to explore the feasibility and optimal strategies for infant vestibular screening.Methods29 infants (58 ears) were divided into two groups according to hearing (group I: normal hearing ears; group II: SNHL ears), 20 healthy adults were defined as group III. The results of response rate, P13 and N23 latency, P13-N23 interval, amplitudes, and corrected interaural asymmetry ratio (IAR) were recorded and compared among three groups.ResultsThe response rates of ACS-cVEMP in three groups were 88.89, 62.00, 100%, respectively. The P13 and N23 latencies, and P13-N23 interval did not differ significantly between group I and II (p = 0.866, p = 0.190, p = 0.252). A significant difference was found between group I and III (p = 0.016, p < 0.001, p < 0.001). No significant difference was observed in raw or corrected amplitude between group I and II (p = 0.741, p = 0.525), while raw and corrected amplitudes in group III were significantly larger than group I (p < 0.001, p < 0.001). For BCV-cVEMP, the response rates in three groups were 100, 86.36, 100%, respectively, No significant difference existed in the P13 and N23 latency, or P13-N23 interval between group I and II (p = 0.665, p = 0.925, p = 0.806), however, P13 and N23 latencies were significantly longer in group III than group I (p < 0.001, p = 0.018), but not in P13-N23 interval (p = 0.110). There was no significant difference in raw or corrected amplitude between group I and II (p = 0.771, p = 0.155) or in raw amplitude between group I and III (p = 0.093), however, a significant difference existed in corrected amplitude between group I and III (p < 0.001).ConclusionsCompared with adults, 3-month-old infants with normal hearing presented with equivalent response rates, shorter P13 and N23 latencies, smaller corrected amplitudes, and a wider IAR range for both ACS and BCV-cVEMP. SNHL infants had equivalent response rates of BCV-cVEMP, lower response rates of ACS-cVEMP than normal hearing infants. When responses were present, characteristics of ACS and BCV-cVEMP in SNHL infants were similar with normal hearing infants. ACS combined with BCV-cVEMP are recommended to improve the accuracy of vestibular screening.

目的 探讨传统226 Hz鼓室图结果为C型儿童的宽频能量吸收率特征,对C型鼓室图在环境压力(0 dapa)及宽频峰压下能量吸收率特征进行分析,建立C型鼓室图宽频声能吸收率曲线范围.方法 选取正常耳140耳及传统226 Hz鼓室图负压耳187耳,通过宽频声导抗测试获取环境压力(0 dapa)及宽频峰压下107个频率下的声能吸收率,绘制C1和C2二组儿童宽频峰压与环境压力(0 dapa)下声能吸收率均值曲线,并对所有曲线进行分析.选取并分析226 Hz和1/3倍频程共17个频率下A组、C1组、C2组儿童宽频能量吸收率是否存在差异.结果 当外耳道为环境压力(0 dapa)时,A组各频率处宽频声能吸收率均大于C组,且C1大于C2组;C1与C2型相比在17个频率中11个存在差异.当外耳道为宽频峰压时,C1组与C2组吸收率均值曲线相似且声能吸收率存在差异频率较少,与A组相比,在中频段更有研究意义.结论 C组与A组宽频声能吸收率存在差异.C1组与C2组声能吸收率曲线主要在外耳道为环境压力下存在差异,而在宽频峰压下相似,可为临床提供一定参考意义.

目的 回顾性分析患分泌性中耳炎(OME)的低龄儿童骨导短声听性脑干反应(ABR)测试结果,确定其中合并感音神经性听力损失(SNHL)患耳所占比例,以及听力损失情况.方法 选择OME组79例(123耳),正常对照组39例(78耳).正常对照组骨导短声ABR阈值平均值+2个标准差,定义为"正常骨导阈值";根据此正常值,将OME组分为骨导正常组(阈值≤正常值)、骨导异常A组(正常值45 dB nHL).分析OME骨导异常A组与正常对照组间的骨导阈值之间是否具有差异;上述OME 3组与正常对照组气导短声ABR阈值间两两比较.结果 骨导短声ABR反应阈正常值为≤22.76 dB nHL.OME组123耳中46耳(37％)存在骨导阈值异常,其中骨导异常A组33耳,骨导异常B组13耳.A组骨导阈值(30.91±7.01 dB nHL)较正常组(14.03±5.00 dB nHL)显著升高(P<0.05).与正常对照组相比,OME 3组的气导阈值均显著提高(P<0.05).OME骨导异常B组的气导阈值(67.69±16.02 dB nHL)较A组的气导阈值(48.33±15.09 dB nHL)显著提高(P<0.05).结论 本组低龄OME儿童中骨导短声ABR反应阈值异常耳超过1/3,其中反应阈>45 dB nHL耳接近1/3,提示其听力损失中存在有OME相关或非相关的SNHL.合并SNHL的低龄OME儿童气导听力损失程度更为严重.骨导短声ABR反应阈测试确定OME儿童是否合并SNHL具有一定的临床应用价值.

目的 探讨分析鼓室图正常、气导短声听性脑干反应(click auditory brainstem response,click-ABR)阈值≤30 dB nHL的婴幼儿畸变产物耳声发射(DPOAE)以及气导500 Hz短纯音听性脑干反应(tone burst-ABR,TB-ABR)的检测结果,为婴幼儿听力损失的早期诊断和评估提供参考.方法 选取2018年1月～2020年12月在我科就诊的中耳功能正常且click-ABR阈值≤30 dB nHL的婴幼儿170例共计272耳作为研究对象,对其临床资料进行整理分析.根据click-ABR阈值分为5组,A组:click-ABR阈值≤10 dB nHL;B组:click-ABR阈值为15 dB nHL;C组:click-ABR阈值为20 dB nHL;D组:click-ABR阈值为25 dB nHL;E组:click-ABR阈值为30 dB nHL.根据DPOAE的测试结果分为4～5个频率点通过组、6点通过组与少于4个频率点未通过组,将6点通过组设为对照组,比较4～5个频率点通过组、未通过组与对照组TB-500 Hz ABR的反应阈是否存在差异.结果 随着click-ABR阈值增大,DPOAE通过率降低,卡方检验显示总体上5组DPOAE的通过率存在显著差异(χ2=72.56,P=0.000).采用Boferroni校正法进行组间多重比较,A、B、C3组间显著差异,D、E两组间无显著差异,A、B、C3组与D、E组间存在显著差异(P<0.05).A、B两组中4～5个频率点通过组的TB-500 Hz ABR阈值与对照组无显著差异(P>0.05),其余各组TB-500 Hz ABR阈值与对照组存在显著差异(P<0.05).结论 当click-ABR阈值≥25 dB nHL时,DPOAE通过率明显降低.对于中耳功能正常且click-ABR阈值≤30 dB nHL的婴幼儿,clcik-ABR≤15 dB nHL但DPOAE未通过以及无论DPOAE是否通过、click-ABR阈值≥20 dB nHL时均需要加做TB-500 Hz ABR评估低频听力.

目的 探究不同听力图曲线听力下降患者语音均衡词表识别与纯音测听阈值的相关性,考察4 kHz听阈对于言语识别的作用.方法 回顾性分析2020年1月～2020年12月于上海交通大学医学院附属新华医院耳鼻咽喉头颈外科就诊的882位患者,共1436耳,按听力图曲线分组,分析0.5、1、2 kHz听阈(PTA3)和0.5、1、2、4 kHz听阈(PTA4)与语音均衡词表最大识别率(PBmax)和言语识别阈(SRT)的相关性,采用多元线性回归分析各频率对于SRT的预测作用.结果 除平坦型听力曲线,各组PTA4与PBmax和SRT相关性均较PTA3高;PTA4对SRT有显著的预测作用;0.5、1、2、4 kHz纯音测听阈值对SRT均有显著的预测作用,2 kHz权重最大,0.5、4、1 kHz依次降低.结论 PTA4与言语测听结果显著相关,能够很好地预测SRT值,在言语听力与纯音听力不成比例下降判断中有应用价值.4 kHz听阈在言语识别中具有重要意义.

目的 探讨分泌性中耳炎儿童宽频声导抗声能吸收率的特征,对比在环境压力(0 daPa)和宽频峰压两种压力下声能吸收率的差异.方法 对分泌性中耳炎儿童49例(80耳)进行宽频声导抗测试,获得107个频率下的声能吸收率,绘制不同外耳给压下频率-吸收率相关曲线,并进行形态学分析.选取并统计226 Hz和1/3倍频程共17个频率下的声能吸收率是否存在差异,并与课题组前期收集到的听力正常同龄段儿童70例(117耳)宽频声能吸收率进行比较分析.结果 无论是在环境压力(0 daPa)还是宽频峰压下,分泌性中耳炎儿童的宽频声能吸收率曲线呈现为先上升后下降的山峰型,其中在3～4 kHz声能吸收率达到最大值.除1000、1260、4000、5040 Hz外,0 daPa和宽频峰压下的宽频声能吸收率均存在统计学差异(P<0.05),且在226～4000 Hz频率间,宽频峰压下声能吸收率较环境压力(0 daPa)下大.与听力正常同龄段儿童比较发现两种外耳道给压下,中耳积液儿童各研究频率声能吸收率均较低.结论 对于分泌性中耳炎儿童,在环境压力(0 daPa)与宽频峰压下,大多频率宽频声导抗声能吸收率存在差异,尽早建立不同中耳状态下宽频声导抗声能吸收率参考范围有助于该技术推广使用.

目的 探讨研究正常儿童中气导声刺激诱发的眼性前庭诱发肌源性电位(oVEMP)和颈性前庭肌源性诱发电位(cVEMP)的各项参数指标,并对正常值进行统计学处理分析.方法 选择4～10岁听力正常健康儿童52例,以500 Hz短纯音作为刺激音,分别行oVEMP和cVEMP检测,记录左、右耳引出率及波形参数,并采用SPSS统计软件进行统计学处理分析.结果 双耳皆未引出oVEMP 2例,单耳可引出oVEMP4例,oVEMP总体引出率为92％.双耳皆未引出cVEMP 2例,cVEMP总体引出率为96％.oVEMP与cVEMP的P1潜伏期分别为(17.07±0.89)ms、(15.55±1.58)ms;N1潜伏期分别为(12.39±0.91)ms、(23.10±2.29)ms;N1P1间期分别为(4.68±0.88)ms、(7.83±1.56)ms;oVEMP与cVEMP的振幅分别为(7.24±4.79)μV、(197.40±118.37)μV.双耳间oVEMP及cVEMP振幅不对称比分别为(19.03±12.50)％、(22.16±18.64)％.患儿左右耳的潜伏期,P1N1间期及振幅差异无统计学意义(P>0.05).结论 绝大部分正常儿童经气导声刺激可引出oVEMP与cVEMP.该检测患儿依从性高,可用来评估儿童前庭功能.此研究结果可为我国的儿童气导VEMP提供正常参考值范围.

目的 比较原发性初发和复发良性阵发性位置性眩晕(BPPV)患者的前庭诱发肌源性电位(VEMPs)特点,探索原发性BPPV屡次复发的可能发病机制.方法 收集首次就诊即确诊为单侧原发性BPPV的患者57例,其中初发患者36例,复发患者21例.所有患者均进行气导声刺激条件下的颈肌VEMP(cVEMP)和眼肌VEMP(oVEMP)检查,对比分析初发组和复发组cVEMP和oVEMP结果的差异.结果 ①初发和复发BPPV组在性别、发病侧别及受累半规管均无统计学差异(P>0.05),年龄存在统计学差异(P<0.05);②57例BPPV患者中21例(36.84％)cVEMP异常,35例(61.40％)oVEMP异常,oVEMP异常率更高(P<0.05);分别对初发组中和复发组中的cVEMP和oVEMP异常率进行比较,结果显示两组oVEMP异常率更高,差异具有统计学意义(P<0.05);③初发BPPV组cVEMP异常有16例(44.45％),复发BPPV组异常有5例(23.81％);初发BPPV组oVEM异常有19例(52.79％),复发BPPV组中oVEMP异常有16例(76.19％);两组cVEMP和oVEMP异常率均无统计学差异(P>0.05);④复发2次组和复发3次以上组,与初发组进行VEMPs异常率比较显示三组间cVEMP及oVEMP异常率均无统计学差异(P>0.05).结论 原发性初发组和复发组BPPV患者的cVEMP和oVEMP异常率差异均无统计学意义,提示耳石器功能异常可能不是原发性BPPV患者反复复发的发病机制.

目的 记录听力正常儿童骨导前庭诱发肌源性电位(BC-VEMP)特征,为临床儿童前庭功能评估提供参考.方法 选择31名(62耳)4～12岁听力正常儿童,按照年龄进行分组,4～5岁组11人(22耳),6～12岁组20人(40耳),行BC-VEMP测试.将60 dB nHL作为起始刺激强度,记录骨导刺激时颈性VEMP(cVEMP)、眼性VEMP(oVEMP)的N1潜伏期、P1潜伏期、N1-P1波间期、N1-P1波幅、波幅不对称比以及阈值.使用SPSS软件进行统计学分析.结果 4～12岁听力正常儿童BC-VEMPs引出率为100％.4～5岁组与6～12岁组相比,BC-cVEMP的P1、N1潜伏期、P1-N1波间期、P1-N1波幅、阈值、波幅不对称比均无统计学差异(P>0.05).两组间BC-oVEMP的N1、P1潜伏期、N1-P1波间期、N1-P1波幅、阈值、波幅不对称比均无统计学差异(P>0.05).结论 BC-VEMPs是一种可行的前庭功能辅助性检査手段,不同年龄段儿童BC-VEMPs正常值的建立,可为儿童前庭功能的评估提供参考.

Objectives: We aimed to investigate the relationship between grades of hearing loss and the presence of acoustically evoked short latency negative response (ASNR) in children with large vestibular aqueduct syndrome (LVAS), so as to enhance the reference value of ASNR for the diagnosis of LVAS in children. Methods: Two hundred sixteen ears from 108 patients (aged 4-90 months) diagnosed with bilateral LVAS, with slight to profound hearing loss, were enrolled in the present study from January 2012 to December 2018. All of the cases were diagnosed with LVAS according to high-resolution computed tomography (HRCT) or magnetic resonance imaging (MRI) scans of the inner ears. The auditory brain stem response (ABR) tests were performed on these subjects with click stimulus (ck-ABR), and the ASNRs were detected based on the method recommended by previous studies. The degree of hearing loss for each ear was classified by the estimated pure-tone average (PTA) thresholds, which were calculated according to the ck-ABR thresholds. Results: ASNRs were present in 40.7% (88/216) ears during ck-ABR tests. Both thresholds of ABR (Z = 2.977, p = 0.003) and estimated PTA (Z = 2.977, p = 0.003) were significantly higher in the ASNR absent group than in the ASNR present group. The frequency of not profound hearing impairment (<= 80 dB HL) was much higher in the ASNR present group (44/88; 50%) than in the ASNR absent group (40/128; 31.3%) (chi(2) = 7.714, p = 0.005). The results of the logistic regression model, adjusted by cases' age and gender, showed that compared with those ears with profound hearing impairment (> 80 dB HL), the not profound impaired ears were associated with a 2.48-fold increased odds of recording ASNR presence in the ck-ABR test [odds ratio (OR) = 2.48, 95% confidence interval (CI): 1.38-4.46, p = 0.003]. Conclusions: Grades of hearing loss affect the presence of ASNR in children with LVAS, and manifesting as cases with not profound hearing impairment showed increased odds of recording ASNR in the ck-ABR test. Furthermore, more studies should be performed imperatively to determine the diagnosis value of ASNR in children with LVAS.