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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Vestibular neuronitis in pilots: follow-up results and implications for flight safety.
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Vestibular neuronitis in pilots: follow-up results and implications for flight safety.

机译：飞行员的前庭神经炎：随访结果及其对飞行安全的影响。

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OBJECTIVES To report our experience over the past 12 years with the evaluation and follow-up of pilots with vestibular neuronitis and to discuss points relevant to flight safety and the resumption of flying duties.STUDY DESIGN A retrospective, consecutive case series.METHODS Eighteen military pilots with vestibular neuronitis were examined and followed up. A complete otoneurological workup was performed, including both physical examination and laboratory evaluation. The latter included electro-oculography (EOG) and a rotatory chair test using the smooth harmonic acceleration protocol.RESULTS The mean patient age was 35 +/- 6 years (range, 23 to 42 y), and the average follow-up period was 20.5 +/- 12.8 months (mean +/- standard deviation [SD]; (range, 11 to 48 mo). Electro-oculography caloric test on presentation documented significant unilateral hypofunction in all patients. Thirteen of the 18 patients (72%) had abnormal smooth harmonic acceleration test results. None of the pilots reported any symptoms on follow-up. However, five (28%) had positive otoneurological examination findings, and eight (44%) still had significant caloric lateralization (>25%). The average caloric hypofunction was reduced from 67.8% +/- 29.3% at onset to 40% +/- 16% (mean +/- SD, <.05, paired test). Seven of the patients (39%) had additional electro-oculography findings beyond caloric hypofunction. These included spontaneous, positional, and positioning nystagmus. Smooth harmonic acceleration disease on follow-up was documented in eight patients (44%), five of whom had canal paresis. Eleven patients (61%) demonstrated residual vestibular damage on follow-up. In 6 of these 11 cases (55%), the laboratory evaluation revealed vestibular deficits otherwise undiagnosed by the bedside test battery.CONCLUSIONS The vestibular system plays a central role in orientation awareness and is often challenged by flying conditions. The finding that approximately 60% of pilots who have had vestibular neuronitis continue to show signs of vestibular malfunction, despite apparent clinical recovery, emphasizes the need for a complete vestibular evaluation, including specific bedside testing and laboratory examinations, before flying duties can be resumed.
机译：目的报告我们在过去12年中对前庭神经炎飞行员的评估和随访的经验，并讨论与飞行安全和恢复飞行职责有关的要点研究设计回顾性连续案例系列方法18名军事飞行员检查并随访前庭神经炎。进行了完整的耳科检查，包括身体检查和实验室评估。后者包括眼电图（EOG）和使用平滑谐波加速方案的旋转椅测试。结果平均患者年龄为35 +/- 6岁（范围23至42岁），平均随访时间为20.5 +/- 12.8个月（平均+/-标准偏差[SD];（范围：11到48 mo）。眼电图热量测试显示所有患者均存在明显的单侧功能减退，这18例患者中有13例（72％）平滑谐波加速度测试结果异常，没有飞行员在随访中出现任何症状，但五名（28％）的耳镜检查结果为阳性，八名（44％）的热量偏侧（> 25％）。平均热量功能减退从发病时的67.8％+/- 29.3％降至40％+/- 16％（平均+/- SD，<。05，配对测试），其中七名患者（39％）接受了额外的电眼部检查发现，除了热功能低下外，还包括自发性，位置性和定位性眼球震颤。随访中有八名患者（44％）记录到谐波加速病，其中五名患有管腔麻痹。 11例患者（61％）在随访中表现出残留的前庭损伤。在这11例病例中的6例（55％）中，实验室评估显示，前床测试电池无法诊断出前庭缺损。结论前庭系统在定向意识中起着核心作用，并且经常受到飞行条件的挑战。尽管有明显的临床恢复，发现约有60％患有前庭神经炎的飞行员继续表现出前庭功能不全的迹象，这强调了在恢复飞行职责之前需要进行全面的前庭评估，包括特定的床旁测试和实验室检查。

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