2 kHz cVEMP与4 kHz oVEMP短纯音在上半规管裂综合征中的敏感性、特异性及可重复性

文献信息

中文摘要

引言： 上半规管裂（SSCD）在内耳形成病理性“第三窗”，导致特征性听觉和前庭症状。尽管0.5 kHz前庭诱发肌源性电位（VEMP）常用，我们旨在评估高频短纯音诱发VEMP的敏感性、特异性及可重复性。
方法： 这项前瞻性、多中心、观察性、纵向研究纳入经高分辨率CT确诊为严格单侧SSCD的成人，以对侧耳作为个体内对照。参与者四周内接受三次访视。采用标准电极放置和95 dB nHL短纯音，每耳每次记录两条曲线，记录颈部（2 kHz）和眼部（4 kHz）VEMP。评估敏感性、特异性、ROC/AUC及可重复性（访视内和访视间）。
结果： 纳入28例严格单侧SSCD患者（平均年龄57.6 ± 12.5岁；17例女性）。未受影响耳未观察到VEMP反应，2 kHz cVEMP和4 kHz oVEMP的特异性均为100%。在三次访视中，裂耳cVEMP的敏感性范围为71.4%至60.7%，oVEMP为60.7%至50.0%。总体而言，所分析的电生理标志物显示出良好至优秀的访视内和访视间可重复性。
结论： 总之，高频VEMP，包括2 kHz cVEMP和4 kHz oVEMP，对检测SSCD耳显示出完美的特异性以及良好至优秀的访视内和访视间可重复性。固定刺激强度95 dB nHL在患者舒适度与测试时长之间提供了平衡。

英文摘要

Introduction Superior semicircular canal dehiscence (SSCD) creates a pathological "third window" in the inner ear, leading to characteristic auditory and vestibular symptoms. Although 0.5 kHz vestibular evoked myogenic potential (VEMPs) are commonly used, we aimed to evaluate the sensitivity, specificity, and reproducibility of VEMPs elicited with high-frequency tone bursts. Methods This prospective, multicenter, observational, longitudinal study included adults with strictly unilateral SSCD confirmed by high-resolution CT, using the contralateral ear as an intra-individual control. Participants attended three visits over four weeks. Cervical (2 kHz) and ocular (4 kHz) VEMPs were recorded with two traces per ear per session using standard electrode placement and 95 dB nHL tone bursts. Sensitivity, specificity, ROC/AUC, and reproducibility (intra- and inter-visit) were assessed. Results Twenty-eight patients with strictly unilateral SSCD were included (mean age 57.6 ± 12.5 years; 17 women). No VEMP responses were observed in unaffected ears, yielding a specificity of 100% for both 2 kHz cVEMPs and 4 kHz oVEMPs. Sensitivity in dehiscent ears ranged from 71.4% to 60.7% for cVEMPs and from 60.7% to 50.0% for oVEMPs across the three visits. Overall, the analyzed electrophysiological markers demonstrated good to excellent intra- and inter-visit reproducibility. Conclusions In conclusion, high-frequency VEMPs, including 2 kHz cVEMPs and 4 kHz oVEMPs, show perfect specificity for detecting ears with SSCD and good to excellent intra- and inter-visit reproducibility. A fixed stimulation intensity of 95 dB nHL provides a balance between patient comfort and test duration.