The Difference Of Vestibular Function Between Sudden Deafness And Vertigo And Vestibular Migraine

Objective To analyze the difference of vestibular function between patients with sudden deafness and vertigo and vestibular migraine,and further to provide reference for rehabilitation therapy.Methods The clinical data of 80 patients with vertigo clinic and hospitalized from ENT Department of Hulunbeier People's Hospital between March 2017 to December 2018 were collected and analyzed.Among them,38 patients showed sudden deafness and vertigo and 42 patients showed vestibular migraine.All patients underwent detailed medical history enquiry and otoscope,followed by pure tone audiometry,Caloric test,video Head impulse test.And vestibular function test results of both patients with sudden deafness and vertigo and vestibular migraine were analyzed.Results 1.Among the 42 patients in the vestibular migraine group,23 patients(54.8%)had abnormal video head pulse,and 13patients(34.2%)had abnormal video head pulse in 38 patients with sudden deafness and vertigo.There was no significant difference in incidence of abnormal head pulse between the two groups(P>0.05).In the vestibular migraine group,10(23.8%)patients of 42 patients had high-gain,13(31.0%)patients had low-gain,and the low-gain ratio was slightly higher than high-gain.But in the sudden deafness and vertigo group,there was only 1(2.6%)patient who had high-gain,12(31.6%)had low-gain.And the low-gain ratio was much higher than high-gain.The high-gain between the two groups was compared and the difference was statistically significant(P < 0.01).But there was no significant difference in low-gain of the two groups(P>0.05).In the vestibular migraine group,12(28.6%)patients had Caloric test abnormality.In the sudden deafness with vertigo group,29(76.3%)patients showed Caloric test abnormalities.The Caloric test abnormalities between the two groups were compared and the difference was statistically significant(P<0.01).2.In the vestibular migraine group,the positive rate of Caloric test was 28.6%,and the counterpart of VHIT was 54.8%.The difference between Caloric test and VHIT positive rate was statistically significant(P<0.05).3.In the sudden deafness with vertigo group,the positive rate of Caloric test was 76.3%,the one of VHIT was 34.2%,and the difference between Caloric test positive rate and VHIT positive rate was statistically significant(P<0.01).4.Among the vestibular migraine group,there was30 patients showed normal Caloric test.Amoung them,6(20.0%)patients had high-gain and8(26.7%)patients had low-gain.In the same group,the Caloric test of 12 patients was abnormal.Amoung these abnormals 4(33.3%)patients had high-gain and 5(41.7%)patients had low-gain.The high-gain and low-gain between the normal and abnormals were compared,and the difference was not statistically significant(P>0.05).5.In the sudden deafness and vertigo group,the Caloric test of 9 patients was normal.Amoung these normal,1 patient(11.1%)had high-gain and no patient(0.0%)had low-gain.And in the same group 29 patients showed abnormal Caloric test.No(0.0%)patient had high-gain and 12(41.4%)patients had low-gain.The high-gain between the normal and abnormals was compared,the difference was not statistically significant(P>0.05),and the low gain between the two groups was compared.The difference was statistically significant(P<0.05).Conclusion 1 The vestibular function in patients with sudden deafness with vertigo shows mainly in the vestibular periphery,with low frequency injury.2 Patients with vestibular migraine may have vestibular peripheral injury,vestibular central injury,or a combination of central and peripheral injury.The video head impulse test in patients with vestibular migraine can show either high-gain or low-gain,which may be related to the pathogenesis of vestibular migraine,the nature and extent of vestibular injury.3 Vestibular function low frequency combined with high frequency examination can improve the detection rate of vestibular damage of vestibular vertigo disease,provide a basis for individualized and rationalized rehabilitation of vestibular disease,help guide and improve prognosis.