A comparative study of detection methods for assessing superior and inferior vestibular nerve damages in patients with vestibular neuritis / 临床耳鼻咽喉头颈外科杂志

Objective:This study aims to compare the examination results of the vestibular evoked myogenic potential（VEMP） and video head impulse testing（vHIT） in patients with vestibular neuritis（VN）, thus exploring the methods to distinguish superior and inferior vestibular nerve damages in VN patients, and their feasibility. Methods:A total of 25 patients with unilateral VN treated in the Otology Department of the First Hospital of Qinhuangdao from May 2018 to July 2021 were recruited. They were respectively tested for ocular VEMP（oVEMP）, cervical VEMP（cVEMP） and vHIT, and the examination results were analyzed. Results:Examination results of oVEMP showed that 96%（24/25） patients had one-ear abnormalities with the amplitude decline or no waveform introduced, and 4%（1/25） patient had no waveform introduced of both ears. The overall abnormal rate examined by oVEMP was 100%（26/26）. Examination results of cVEMP showed that 36%（9/25） patients had one-ear abnormalities with the amplitude decline or no waveform introduced, and 4%（1/25） patients had no waveform introduced of both ears. The overall abnormal rate examined by cVEMP was 40%（10/25）, and 60%（15/25） patients had normal waveforms of both ears. Examination results of vHIT showed that 100%（25/25） patients had semicircular canal gain decline of one side, 92%（23/25） had anterior Semicircular canal decline of one side, and 36%（9/25） had posterior semicircular canal decline of one side. VEMP and vHIT results were compared. Examination results of VEMP showed that 60%（15/25） VN patients had superior vestibular nerve damage, and 40%（10/25） had both superior and inferior vestibular nerve damages. Examination results of vHIT showed that 64%（16/25） VN patients had superior vestibular nerve damage, and 36%（9/25） had both superior and inferior vestibular nerve damages. There was no significant difference in the ratio of VN patients with superior and inferior vestibular nerve damages examined by VEMP or vHIT（χ²=0.085, P>0.05）. The matching ratio of VEMP and vHIT results was 80%（20/25）, and the non-matching ratio was 20%（5/25）. Conclusion:Consistent results obtained from both VEMP and vHIT can preliminarily identify the type of vestibular nerve damage. If their results are not consistent, it is recommended not to identify the scope of the vestibular nerve damage.

Efficacy of cochlear implantation for bilateral severe Ménière's disease / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the effecacy of cochlear implantation (CI) improving hearing of Lermoyez's syndrome, we retrospectively analyzed a case of Lermoyez's syndrome whose left ear was extremely severe sensorineural deafness and right ear was severe sensorineural deafness.@*METHOD@#The patient had completed preoperative audiological examination , vestibular function and imaging examination, then was carried out bilateral endolymphatic sac decompression and left side CI. Follow up after the surgery.@*RESULT@#The vertigo could be controlled very well after the bilateral endolymphatic sac decompression surgery, but the hearing loss couldn't be control, so CI was carried out to improve hearing and speech recognition rate. The contralateral hearing also improved significantly after the operation.@*CONCLUSION@#Endolymphatic sac decompression can effectively control. Ménière's disease in patients with vertigo attacks. CI can improve patients' hearing, and speech recognition rate and, also could improve the quality of life. CI was the first choice for the patient of 4 stage Ménière's disease.