Introduction:The masseter vestibular evoked myogenic potential(mVEMP)is a bilaterally generated,electromyographically(EMG)-mediated response innervated by the trigeminal nerve.The purpose of the present investigation ...Introduction:The masseter vestibular evoked myogenic potential(mVEMP)is a bilaterally generated,electromyographically(EMG)-mediated response innervated by the trigeminal nerve.The purpose of the present investigation was to 1)determine whether subjects could accurately achieve and maintain a range of EMG target levels,2)to examine the effects of varied EMG levels on the latencies and amplitudes of the mVEMP,and 3)to investigate the degree of side-to-side asymmetry and any effects of EMG activation.Methods:Subjects were nine neurologically and otologically normal young adults.A high-intensity tone burst was presented monaurally while subjects were seated upright and asked to match a range of EMG target levels by clenching their teeth.Recordings were made from the ipsilateral and contralateral masseter muscles referenced to the ear being monaurally stimulated.Results:We found that the tonic EMG target had no effect on mVEMP latency.Additionally,although mVEMP amplitudes“scaled”to the EMG target,there was a tendency for the subjects’EMG level to“undershoot”the EMG target levels greater than 50 mV.While some individuals did generate differences in EMG activation between sides,there were no significant differences on average EMG activation between sides.Further,while average corrected amplitude asymmetry was similar across EMG targets,some individuals demonstrated large,corrected amplitude asymmetry ratios.Conclusions:The results of this investigation suggest that,as with cVEMP recordings,the underlying EMG activation may vary between subjects and could impact mVEMP amplitudes,yet could be mitigated by amplitude correction techniques.Further it is important to be aware that even young normal subjects have difficulty maintaining large,tonic EMG activity during the mVEMP recording.展开更多
Profound sensorineural hearing loss (PSHL) is not uncommonly encountered in otology. In clinics, there is a high incidence of otolithic damage in patients with PSHL, but relevant reports are few. Sharing a continuous ...Profound sensorineural hearing loss (PSHL) is not uncommonly encountered in otology. In clinics, there is a high incidence of otolithic damage in patients with PSHL, but relevant reports are few. Sharing a continuous membranous structure and similar receptor cell ultrastructures, the cochlea and vestibule may be susceptible to the same harmful factors. Disorders of the inner ear may result in a variety of manifestations, including vertigo, spatial disorientation, blurred vision, impaired articulation, and hearing impairment. Considering the diversity of clinical symptoms associated with PSHL with otolithic dysfunction, it may be frequently misdiagnosed, and objective means of testing the function of otolithic organs should be recommended for hearing-impaired patients. Vestibular-evoked myogenic potentials (VEMPs) via air-conducted sound are of great importance for the diagnosis of otolithic function. Hearing devices such as cochlear implants are commonly accepted treatments for PSHL, and early identification and treatment of vestibular disorders may increase the success rate of cochlear implantation. Therefore, it is necessary to increase awareness of otolithic functional states in patients with PSHL.展开更多
Introduction:Osteoporosis and osteopenia are progressive disorders characterized by decreased bone mass,especially in postmenopausal women.These can be associated with body pain,fractures,hearing loss and balance diso...Introduction:Osteoporosis and osteopenia are progressive disorders characterized by decreased bone mass,especially in postmenopausal women.These can be associated with body pain,fractures,hearing loss and balance disorders.The present study aims to evaluate audio-vestibular function in postmenopausal patients with osteopenia or osteoporosis.Methods:The study included 48 postmenopausal women(new subjects)diagnosed with osteoporosis(n=23)or osteopenia(n=25)in the age range of 50e66 years,as well as 28 normal women as controls.Audiological testing included pure tone audiometry(conventional and extended high-frequency audiometry),speech audiometry,impedance audiometry and otoacoustic emissions,including both transient evoked otoacoustic emissions(TEOAEs)and distortion product otoacoustic emissions(DPOAEs).All subjects also underwent vestibular evoked myogenic potentials testing(both ocular and cervical VEMPs).Results:In the present study,hearing was worse at all frequencies in the osteoporosis group in comparison with the osteopenia and control groups,with worse speech recognition and discrimination scores and OAEs.Vestibular function was affected in 95.65%of women with osteoporosis and 76%of those with osteopenia.Conclusion:Osteoporosis and osteopenia are risk factors for vestibular dysfunction and hearing deficits in postmenopausal women.Thus,hearing and vestibular function should be monitored by audiological and vestibular testing periodically in these individuals.展开更多
Pilot spatial disorientation is a leading factor contributing to many fatal flying accidents. Spatial orientation is the product of integrative inputs from the proprioceptive, vestibular, and visual systems. Vestibula...Pilot spatial disorientation is a leading factor contributing to many fatal flying accidents. Spatial orientation is the product of integrative inputs from the proprioceptive, vestibular, and visual systems. Vestibular neuritis (VN) can lead to sudden pilot incapacitation in flight. VN is commonly diagnosed by demonstration of unilateral vestibular failure, as unilateral loss of caloric response. As this test reflects the function of the superior part of the vestibular nerve only, cases of pure inferior nerve neuritis will be lost. This paper describes a fighter pilot with symptoms suggestive of VN but with normal caloric test results. Further test showed unilateral loss of vestibular evoked myogenic potential. We believe that the pilot suffered from pure inferior nerve vestibular neuritis. VEMP plays a major role in the diagnosis of inferior nerve vestibular neuritis in pilots. Aeromedical concerns are also discussed.展开更多
Objective To study the integrity of vestibular brain stem pathway and explore the diagnostic and clinical value of vestibular-evoked myogenic potentials ( VEMPs) in central nervous system diseases through the establis...Objective To study the integrity of vestibular brain stem pathway and explore the diagnostic and clinical value of vestibular-evoked myogenic potentials ( VEMPs) in central nervous system diseases through the establishment of detection method of VEMPs.展开更多
目的:颈前庭诱发肌源性电位(cVEMP)测试在评估球囊和末梢前庭神经功能方面有重要的临床意义,也可评估上半规管裂综合征(SCD)患者对声音的前庭超敏性。cVEMP测试使用的常规刺激是高强度500Hz的短纯音。本研究的目的是比较高强度短纯音和...目的:颈前庭诱发肌源性电位(cVEMP)测试在评估球囊和末梢前庭神经功能方面有重要的临床意义,也可评估上半规管裂综合征(SCD)患者对声音的前庭超敏性。cVEMP测试使用的常规刺激是高强度500Hz的短纯音。本研究的目的是比较高强度短纯音和低强度的click,诊断SCD的有效性。方法:研究38例单侧SCD患者对500Hz的短纯音和click响应的cVEMP振幅。结果:采用高强度500 Hz短纯音的cVEMP测试不能区分SCD患者。高强度500Hz的刺激可能饱和。使用90和80dB nHL clicks少有饱和度。用80和90dB nHL clicks测试与只用90dB nHL clicks相比,并没有明显的优势。结论:90dB nHL clicks和高强度500 Hz的短纯音cVEMP,都可用于筛查SCD。展开更多
文摘Introduction:The masseter vestibular evoked myogenic potential(mVEMP)is a bilaterally generated,electromyographically(EMG)-mediated response innervated by the trigeminal nerve.The purpose of the present investigation was to 1)determine whether subjects could accurately achieve and maintain a range of EMG target levels,2)to examine the effects of varied EMG levels on the latencies and amplitudes of the mVEMP,and 3)to investigate the degree of side-to-side asymmetry and any effects of EMG activation.Methods:Subjects were nine neurologically and otologically normal young adults.A high-intensity tone burst was presented monaurally while subjects were seated upright and asked to match a range of EMG target levels by clenching their teeth.Recordings were made from the ipsilateral and contralateral masseter muscles referenced to the ear being monaurally stimulated.Results:We found that the tonic EMG target had no effect on mVEMP latency.Additionally,although mVEMP amplitudes“scaled”to the EMG target,there was a tendency for the subjects’EMG level to“undershoot”the EMG target levels greater than 50 mV.While some individuals did generate differences in EMG activation between sides,there were no significant differences on average EMG activation between sides.Further,while average corrected amplitude asymmetry was similar across EMG targets,some individuals demonstrated large,corrected amplitude asymmetry ratios.Conclusions:The results of this investigation suggest that,as with cVEMP recordings,the underlying EMG activation may vary between subjects and could impact mVEMP amplitudes,yet could be mitigated by amplitude correction techniques.Further it is important to be aware that even young normal subjects have difficulty maintaining large,tonic EMG activity during the mVEMP recording.
文摘Profound sensorineural hearing loss (PSHL) is not uncommonly encountered in otology. In clinics, there is a high incidence of otolithic damage in patients with PSHL, but relevant reports are few. Sharing a continuous membranous structure and similar receptor cell ultrastructures, the cochlea and vestibule may be susceptible to the same harmful factors. Disorders of the inner ear may result in a variety of manifestations, including vertigo, spatial disorientation, blurred vision, impaired articulation, and hearing impairment. Considering the diversity of clinical symptoms associated with PSHL with otolithic dysfunction, it may be frequently misdiagnosed, and objective means of testing the function of otolithic organs should be recommended for hearing-impaired patients. Vestibular-evoked myogenic potentials (VEMPs) via air-conducted sound are of great importance for the diagnosis of otolithic function. Hearing devices such as cochlear implants are commonly accepted treatments for PSHL, and early identification and treatment of vestibular disorders may increase the success rate of cochlear implantation. Therefore, it is necessary to increase awareness of otolithic functional states in patients with PSHL.
文摘Introduction:Osteoporosis and osteopenia are progressive disorders characterized by decreased bone mass,especially in postmenopausal women.These can be associated with body pain,fractures,hearing loss and balance disorders.The present study aims to evaluate audio-vestibular function in postmenopausal patients with osteopenia or osteoporosis.Methods:The study included 48 postmenopausal women(new subjects)diagnosed with osteoporosis(n=23)or osteopenia(n=25)in the age range of 50e66 years,as well as 28 normal women as controls.Audiological testing included pure tone audiometry(conventional and extended high-frequency audiometry),speech audiometry,impedance audiometry and otoacoustic emissions,including both transient evoked otoacoustic emissions(TEOAEs)and distortion product otoacoustic emissions(DPOAEs).All subjects also underwent vestibular evoked myogenic potentials testing(both ocular and cervical VEMPs).Results:In the present study,hearing was worse at all frequencies in the osteoporosis group in comparison with the osteopenia and control groups,with worse speech recognition and discrimination scores and OAEs.Vestibular function was affected in 95.65%of women with osteoporosis and 76%of those with osteopenia.Conclusion:Osteoporosis and osteopenia are risk factors for vestibular dysfunction and hearing deficits in postmenopausal women.Thus,hearing and vestibular function should be monitored by audiological and vestibular testing periodically in these individuals.
基金supported by the National Natural Science Foundation of China (Grant No. 30871220)
文摘Pilot spatial disorientation is a leading factor contributing to many fatal flying accidents. Spatial orientation is the product of integrative inputs from the proprioceptive, vestibular, and visual systems. Vestibular neuritis (VN) can lead to sudden pilot incapacitation in flight. VN is commonly diagnosed by demonstration of unilateral vestibular failure, as unilateral loss of caloric response. As this test reflects the function of the superior part of the vestibular nerve only, cases of pure inferior nerve neuritis will be lost. This paper describes a fighter pilot with symptoms suggestive of VN but with normal caloric test results. Further test showed unilateral loss of vestibular evoked myogenic potential. We believe that the pilot suffered from pure inferior nerve vestibular neuritis. VEMP plays a major role in the diagnosis of inferior nerve vestibular neuritis in pilots. Aeromedical concerns are also discussed.
文摘Objective To study the integrity of vestibular brain stem pathway and explore the diagnostic and clinical value of vestibular-evoked myogenic potentials ( VEMPs) in central nervous system diseases through the establishment of detection method of VEMPs.
文摘目的:颈前庭诱发肌源性电位(cVEMP)测试在评估球囊和末梢前庭神经功能方面有重要的临床意义,也可评估上半规管裂综合征(SCD)患者对声音的前庭超敏性。cVEMP测试使用的常规刺激是高强度500Hz的短纯音。本研究的目的是比较高强度短纯音和低强度的click,诊断SCD的有效性。方法:研究38例单侧SCD患者对500Hz的短纯音和click响应的cVEMP振幅。结果:采用高强度500 Hz短纯音的cVEMP测试不能区分SCD患者。高强度500Hz的刺激可能饱和。使用90和80dB nHL clicks少有饱和度。用80和90dB nHL clicks测试与只用90dB nHL clicks相比,并没有明显的优势。结论:90dB nHL clicks和高强度500 Hz的短纯音cVEMP,都可用于筛查SCD。
