Korean Journal of Otorhinolaryngology-Head and Neck Surgery

  • 제61권11호
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  • Pages.580-587
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  • 2018
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  • 2092-5859(pISSN)
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  • 2092-6529(eISSN)
대한이비인후과학회 (Korean Society of Otolaryngology-Head and Neck Surgery)
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일측 전정기능 저하 환자에서 방향전환 진동유발안진의 임상적 의의와 발생 기전 제안

Clinical Implication and Proposed Mechanism of Direction Changing Vibration Induced Nystagmus in Unilateral Vestibular Hypofunction

  • 이동한 (서울대학교병원 이비인후과) ;
  • 박무균 (서울대학교병원 이비인후과) ;
  • 이준호 (서울대학교병원 이비인후과) ;
  • 오승하 (서울대학교병원 이비인후과) ;
  • 서명환 (서울대학교병원 이비인후과)
  • Lee, Dong Han (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital) ;
  • Park, Moo Kyun (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital) ;
  • Lee, Jun Ho (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital) ;
  • Oh, Seung-Ha (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital) ;
  • Suh, Myung-Whan (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital)
  • 투고 : 2017.09.15
  • 심사 : 2018.01.08
  • 발행 : 2018.11.25
⟨ 이전 논문 다음 논문 ⟩

초록

Background and Objectives We evaluated the clinical characteristics and vestibular function of patients with direction changing vibration induced nystagmus (DC VIN) and unilateral vestibular hypofunction and suggest clinical implication and a proposed mechanism of DC VIN. Subjects and Method The records of 315 patients who underwent the VIN test were reviewed retrospectively. Among these, 18 patients (5.7%) showed DC VIN, and out of whom, 15 patients (4.8%) were diagnosed as unilateral vestibular hypofunction by caloric, rotation chair (RCT), and video head impulse test (vHIT). We analyzed the relationship between DC VIN and the dizziness characteristics, duration of disease, and the outcome of the vestibular function test. Results The mean age of 15 patients was $67.4{\pm}10.7years$ and the mean duration of dizziness was $13.6{\pm}29.7months$. The caloric test revealed 25% of the patients to have significant canal paresis [Caloric vestibular neuritis (VN)], while 75% showed normal caloric response. However, unilateral vestibular hypofunction was observed by abnormal results in RCT or vHIT (Non-caloric VN). Seven patients showed ipsilateral DC VIN (nystagmus to vibrated side) and eight patients contralateral DC VIN (nystagmus to opposite side of vibration). Patients with ipsilateral DC VIN were shown to have a significant longer duration of dizziness than those with contralateral DC VIN. Conclusion Although rare, DC VIN can also be found in patients with unilateral vestibular hypofunction. Patients with DC VIN had a mild vestibular asymmetry with Non-caloric VN or Caloric VN in the process of compensation. The mechanism of ipsilateral DC VIN seems to be due to the small amount of vestibular asymmetry, which is smaller than the interaural attenuation of vibration.

키워드

과제정보

연구 과제 주관 기관 : Seoul National University Hospital

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