The Bithermal Test and Pure Tone Test for Patients with Idiopathic Benign Paroxysmal Positional Vertigo_West China Medical Journal

Authors：

LI Daibo , DAI Qingqing , YIN Rong ,  ZHENG Hong

West China Hospital, West China Medical, School Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

ZHENG Hong, Email: lxx0504@126.com

Keywords：

原发性良性阵发性位置性眩晕; 双温试验; 听力

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【摘要】　目的　了解原发性良性阵发性位置性眩晕（benign paroxysmal positional vertigo，BPPV）的双温试验及纯音测听结果临床特点。　方法　 2009年6月—2010年6月诊断为原发性BPPV患者54例，于手法复位前行双温试验及纯音听阈测试，分析原发性BPPV患者的双温试验、纯音测听结果的临床特点。　结果　 40例患耳无半规管轻瘫，其病程为（4.25±2.75）周，14例患耳半规管轻瘫，其病程为（9.21±5.85）周，两组间平均病程差异具有统计学意义（t=4.235，P lt;0.05）；39例后半规管BPPV中11例患耳半规管轻瘫，15例水平半规管BPPV中3例患耳半规管轻瘫，两组患耳半规管轻瘫发生率无统计学意义（χ2=2.679，P gt;0.05）；39例后半规管BPPV中16例患耳听力下降，15例水平半规管BPPV中7例患耳听力下降，两组患耳纯音测听异常率无明显统计学差异（χ2=0.141，P gt;0.05）。　结论　原发性后半规管BPPV与水平半规管BPPV半规管轻瘫及纯音听阈异常发生率相近，病程长者更易出现半规管轻瘫。
【Abstract】　Objective　 To investigate the clinical features of results of bithermal test and pure tone test for patients with idiopathic benign paroxysmal positional vertigo (BPPV), and discuss strategies for prevention. 　Methods　 A total of 54 patients diagnosed to have BPPV during June 2009 to June 2010 underwent bithermal caloric test and pure tone test before particle repositioning maneuver. Then, we analyzed the clinical features of the test results. 　Results　 The course of 40 patients with canal paresis (CP) was (4.25±2.75) weeks, which had a significant difference from the course of 14 patients with CP in the abnormal side, which was (9.21±5.85) weeks (t=4.235, P lt;0.05). Among the 39 patients with posterior semicircular canal benign paroxysmal positional vertigo (PSC-BPPV), 11 cases of canal paresis were found in the abnormal ear, and of the 15 patients with horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV), 3 cases of canal paresis were found. There was no statistical difference in the rate of canal paresis between the two groups of patients mentioned above (χ2=2.679,P gt;0.05). Sixteen out of the 39 PSC-BPPV patients and seven out of the 15 HSC-BPPV patients had hearing loss (HL) in the abnormal ear with no statistical difference between the two groups of patients in the incidence of hearing loss (χ2=0.141,P gt;0.05). 　Conclusion　 The incidence of CP and HL in the abnormal ear of patients with HSC-BPPV and PSC-BPPV is similar, and patients with long course of disease are more likely to have CP.

Citation： LI Daibo,DAI Qingqing,YIN Rong,ZHENG Hong. The Bithermal Test and Pure Tone Test for Patients with Idiopathic Benign Paroxysmal Positional Vertigo. West China Medical Journal, 2011, 26(5): 726-729. doi: Copy

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9.	Karlsen EA, Hassanein RM, Goetzinger CP. The effects of age, sex, hearing loss and water temperature on caloric nystagmus[J]. Laryngoscope, 1981, 91(4): 620-627.
10.	Wetmore SJ. Extended caloric tests[J]. Ear Hearing, 2007, 7(3): 186-190.
11.	Bachor E, Wright CG, Karmody CS. The incidence and distribution of cupular deposits in the pediatric vestibular labyrinth[J]. Laryngoscope, 2002, 112(1): 147-151.
12.	Baloh RW, Honrubia V, Jacoboson K. Benign positional vertigo: clinical and oculographic features in 240 cases[J]. Neurology, 1987, 37(3): 371-378.
13.	Fetter M, Dichgans J. Three-dimensional human VOR in acute vestibular lesions[J]. Ann N Y Acad Sci, 1996, 781(6): 619-621.
14.	Aw ST, Haslwanter T, Fetter M, et al. Contribution of the vertical semicircular canals to the caloric nystagmus[J]. Acta Otolaryngol, 1998, 118(5): 618-627.

1. 　Molina MI, López-Escámez JA, Zapata C. Monitoring of caloric response and outcome in patients with benign paroxysmal positional vertigo[J]. Otol Neurotol, 2007, 28(6): 798-800.
2. 　高波, 宋海涛, 黄魏宁, 等. 良性阵发性位置性眩晕患者温度试验结果比较[J].中国耳鼻咽喉头颈外科, 2008, 16(8): 410-412.
3. 　吴子明, 张素珍, 周娜. 良性阵发性位置性眩晕的听——前庭功能研究[J]. 中华耳鼻咽喉头颈外科, 2006, 4(9): 669-672.
4. 　中华耳鼻咽喉头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉科学分会. 良性阵发性位置性眩晕的诊断依据和疗效评估[J]. 中华耳鼻咽喉头颈外科杂志, 2007, 42(3): 163-164.
5. 　von Brevern M, Schmidt T, Schnfeld U, et al. Utricular dysfunction in patients with benign paroxysmal positional vertigo[J]. Otol Neurotol, 2006, 27(1): 92-96.
6. 　Yang WS, Kim SH, Lee JD, et al. Clinical significance of vestibular evoked myogenc potentials in benign paroxysmal positional vertigo[J]. Otol Neurotol, 2008, 29(1): 1162-1166.
7. 　Gentine A, Eichhorn JL, Kopp C, et al. Modelling the action of caloric stimulation of the vestibule. I. The hydrostatic model[J]. Acta Otolaryngol, 1990, 110(5): 328-333.
8. 　Gentine A, Eichhorn JL, Kopp C, et al. Modelling the action of caloric stimulation of the vestibule. Ⅱ. The mechanical model of the semi-circular canal considered as an inflatable structure[J]. Acta Otolaryngol, 1991, 111(1): 7-10.
9. 　Karlsen EA, Hassanein RM, Goetzinger CP. The effects of age, sex, hearing loss and water temperature on caloric nystagmus[J]. Laryngoscope, 1981, 91(4): 620-627.
10. 　Wetmore SJ. Extended caloric tests[J]. Ear Hearing, 2007, 7(3): 186-190.
11. 　Bachor E, Wright CG, Karmody CS. The incidence and distribution of cupular deposits in the pediatric vestibular labyrinth[J]. Laryngoscope, 2002, 112(1): 147-151.
12. 　Baloh RW, Honrubia V, Jacoboson K. Benign positional vertigo: clinical and oculographic features in 240 cases[J]. Neurology, 1987, 37(3): 371-378.
13. 　Fetter M, Dichgans J. Three-dimensional human VOR in acute vestibular lesions[J]. Ann N Y Acad Sci, 1996, 781(6): 619-621.
14. 　Aw ST, Haslwanter T, Fetter M, et al. Contribution of the vertical semicircular canals to the caloric nystagmus[J]. Acta Otolaryngol, 1998, 118(5): 618-627.

West China Medical Journal

The Bithermal Test and Pure Tone Test for Patients with Idiopathic Benign Paroxysmal Positional Vertigo

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