前庭诱发肌源性电位对急性单侧前庭病的诊断效能：系统评价与荟萃分析
Diagnostic Performance of Vestibular-Evoked Myogenic Potentials for Acute Unilateral Vestibulopathy: A Systematic Review and Meta-analysis.
文献信息
| PMID | 42788762 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Mikhael Makhoul |
| 作者单位 | Service d'ORL, Otoneurologie et ORL pédiatrique, CHU Toulouse Purpan, Toulouse, France. |
| 期刊 | Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.9 |
| 研究类型 | 综述 Meta · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 本研究旨在评估颈部（cVEMP）和眼部（oVEMP）前庭诱发肌源性电位对急性单侧前庭病的汇总诊断效能。
数据来源： 检索MEDLINE、EMBASE、Scopus和Cochrane Central数据库中从建库至2025年10月的相关文章。
综述方法： 我们纳入了评估cVEMP和oVEMP在成人患者中诊断急性单侧前庭病效能的前瞻性、回顾性和横断面研究。采用随机效应分析计算cVEMP和oVEMP诊断急性单侧前庭病的敏感度和特异度的汇总估计值，该分析在存在异质性时予以考虑。构建森林图以合并系统评价中识别的证据。
结果： 共纳入41项研究；其中15项贡献了诊断准确性荟萃分析（519例患者，577例对照）。cVEMP的汇总敏感度为40%（95% CI，0.30-0.50；I2 = 64.2%），特异度为100%（95% CI，0.00-1.00；I2 = 0%）。oVEMP的汇总敏感度为74%（95% CI，0.57-0.86；I2 = 55.9%），特异度为99%（95% CI，0.88-1.00；I2 = 0%）。异常率cVEMP为40%（633/1540；I2 = 85.2%），oVEMP为67%（679/1135；I2 = 92.7%）。亚组分析显示，气导声刺激（76%）和短纯音刺激（82%）可提高oVEMP的敏感度，而骨导振动诱发时cVEMP的敏感度更优（49% vs 气导声刺激的37%）。
结论： VEMP在诊断急性单侧前庭病方面显示出高特异度但中等敏感度，其中oVEMP优于cVEMP，因为上前庭神经受累更为常见。因此，VEMP应作为补充性检查而非独立检查，与临床检查和基于半规管的检查联合使用。
英文摘要
OBJECTIVE: The goal of this study is to evaluate the pooled diagnostic performance of cervical (cVEMP) and ocular (oVEMP) vestibular-evoked myogenic potentials for Acute Unilateral Vestibulopathy.
DATA SOURCES: MEDLINE, EMBASE, Scopus, and Cochrane Central were searched for relevant articles from inception to October 2025.
REVIEW METHODS: We included prospective, retrospective, and cross-sectional studies evaluating the performance of cVEMP and oVEMP for the diagnosis of acute unilateral vestibulopathy in adult patients. The pooled estimates of the sensitivity and specificity of cVEMP and oVEMP in the diagnosis of acute unilateral vestibulopathy were calculated using a random-effects analysis that accounts for heterogeneity if present. Forest plots were constructed to combine the evidence identified during the systematic review.
RESULTS: Forty-one studies were included; 15 contributed to diagnostic accuracy meta-analyses (519 patients, 577 controls). Pooled cVEMP sensitivity was 40% (95% CI, 0.30-0.50; I2 = 64.2%) and specificity 100% (95% CI, 0.00-1.00; I2 = 0%). Pooled oVEMP sensitivity was 74% (95% CI, 0.57-0.86; I2 = 55.9%) and specificity 99% (95% CI, 0.88-1.00; I2 = 0%). Abnormality rates were 40% for cVEMP (633/1540; I2 = 85.2%) and 67% for oVEMP (679/1135; I2 = 92.7%). Subgroup analyses revealed enhanced oVEMP sensitivity with air-conducted sound (76%) and tone-burst stimuli (82%), while cVEMP achieved superior sensitivity when elicited by bone-conducted vibration (49% vs 37% with air-conducted sound).
CONCLUSION: VEMPs show high specificity but moderate sensitivity for diagnosing acute unilateral vestibulopathy, with oVEMP outperforming cVEMP because superior vestibular nerve involvement is more common. Therefore, VEMPs should be used as complementary rather than standalone tests alongside clinical and canal-based tests.