Analysis Of Vestibular Function Test And Vestibular Rehabilitation Results

Background and Objective Dizziness is a common clinical symptom involving otolaryngology,neurology,cardiology,orthopedics,ophthalmology,psychiatry and many other departments.According to the national health interview survey in the United States,60% of the more than 7 million people over the age of 65 have experienced dizziness.An epidemiological survey in China showed that the prevalence of vertigo in people over 10 years old was 4.1%.Common vertigo includes Benign Paroxysmal Positional Vertigo(BPPV),Vestibular Migraine(VM),Meniere's Disease(MD),Vestibular Neuritis(VN)),sudden deafness with vertigo and so on.Many diseases are difficult to identify because of the similar clinical manifestations,and have poor efficacy.Patients are repeatedly visited in multiple departments and hospitals.Therefore,research on vertigo at home and abroad is paying more and more attention.The nystagtomograph(VNG)is a video recording of eye movements,including eye movement testing and thermal testing.The video head impulse test(v HIT)is a video eyewear test based on bedside inspection.v HIT can detect the high frequency function of six semicircular canals separately,which makes up for the shortcomings of the low temperature function of horizontal semicircular canal in cold and hot test.Vestibular migraine and Meniere's disease are common recurrent vertigos,and the clinical symptoms overlap.When there are hearing symptoms in VM,or there is no hearing symptoms in early MD,there are many difficulties in the differential diagnosis.Whether VNG combined v HIT examination can provide a basis for the differential diagnosis of the two is still lack of corresponding research.Vestibal rehabilitation therapy(VRT)is a physical therapy method.In the 1940 s,Cawthorne and Cooksey proposed that the balance of the human body is maintained by multiple systems,and that damage to one system can be compensated by exercising other systems.In 1972,Mc Cabe extended the concept of Cawthorne and Cooksey,and for the first time proposed vestibular rehabilitation to reduce recurrent,prolonged vertigo.In 1989,Igarashi et al.found that after unilateral vestibular nerve resection,exercise was faster than vestibular compensation in animals that did not exercise,and exercise accelerated the recovery of vestibular function.In recent years,the application of VRT in the field of vertigo has grown exponentially,and its application in some vertigo diseases has achieved certain effects,but there are few applications in VM,MD,sudden deafness with vertigo,and VRT does not form a set.The application of timing,dosage and specific methods for a complete and standardized individualized treatment plan needs to be explored.In this study,the VNG combined with v HIT examination were used to analyze the vestibular function of patients with vertigo in otolaryngology.To explore the value of VNG combined with v HIT in the differential diagnosis of Meniere's disease and vestibular migraine with intermittent vestibular symptoms.Individualized vestibular rehabilitation prescriptions were developed according to the patient's cause,to observe the therapeutic effect of VRT in vertigo and explore its clinical application value.Methods 246 patients with vertigo who were admitted to our hospital from June 2017 to October 2018 were selected according to different diagnostic criteria,including 96 BPPV,54 VM,48 MD,28 VN,and 20 sudden deafness with vertigo.All patients underwent vestibular function tests to analyze the vestibular function of each type of disease.The vestibular function of each type of disease was randomly divided into the experimental group and the control group.The experimental group was treated with drug treatment plus VRT,but the control group was only treated with drugs.The DHI scale was used to compare the efficacy of the two groups before and after treatment.SPSS19.0 was used for statistical analysis.Results 1.There was no significant difference between the cold and hot test of VM and the abnormal rate of v HIT,and they were much lower than the abnormal rate of eye movement function(p <0.05).The abnormal rate of BPPV,MD,sudden deafness with vertigo were higher,and the abnormal rate of v HIT were lower,there was significant difference(p < 0.05);The cold and hot test and the v HIT abnormal rate of VN were both high and there was no significant difference(p > 0.05).The abnormal rate of eye movement detection of VM was higher than that of MD,and the abnormal rate of cold and heat test and v HIT was lower than that of MD(p <0.05).2.There was no significant difference in DHI recovery between the BPPV group and the control group after one week(P>0.05).The recovery of DHI in all peripheral vertigo patients was higher than that in the control group after one month(p <0.05).Conclusions 1.VM with vestibular symptoms in the intermittent phase are mainly characterized by central vestibular dysfunction.BPPV,MD,sudden deafness with vertigo are mainly low-frequency semicircular canal function damage.The high-frequency function is relatively reserved;VN is mainly based on full-frequency semi-regulatory function damage.The VNG combined with v HIT examination can provide a basis for the differential diagnosis of VM and MD.2.For acute vertigo vestibular neuritis,sudden deafness with vertigo,VRT should be started as soon as possible;For recurrent vertigo with vestibular symptoms,vestibular migraine,meniere's disease,residual symptoms after BPPV successful maneuver reduction,VRT can play a therapeutic role.VRT has a universal and effective application value in vertigo treatment.It is the key to choose the appropriate method and treatment timing.