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首页> 外文期刊>Archives of otolaryngology--head & neck surgery. >Balance dysfunction and recovery after surgery for superior canal dehiscence syndrome
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Balance dysfunction and recovery after surgery for superior canal dehiscence syndrome

机译：上管裂开综合征的平衡功能障碍和术后恢复

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Objective: To characterize (1) the impairment and recovery of functional balance and (2) the extent of vestibular dysfunction and physiological compensation following superior canal dehiscence syndrome (SCDS) surgical repair. Design: Prospective study. Setting: Tertiary referral center. Participants: Thirty patients diagnosed as having SCDS. Interventions: Surgical plugging and resurfacing of SCDS. Main Outcome Measures: Balance measures were assessed in 3 separate groups, each with 10 different patients: presurgery, postoperative short-term (<1 week), and postoperative long-term (≥6 weeks). Vestibular compensation and function, including qualitative head impulse tests (HITs) in all canal planes and audiometric measures, were assessed in a subgroup of 10 patients in both the postoperative short-term and long-term phases. Results: Balance measures were significantly impaired immediately but not 6 weeks after SCDS repair. All patients demonstrated deficient vestibulo-ocular reflexes for HITs in the plane of the superior canal following surgical repair. Unexpectedly, spontaneous or post-head-shaking nystagmus beat ipsilesionally in most patients, whereas contrabeating nystagmus was noted only in patients with complete canal paresis (ie, positive HITs in all canal planes). There were no significant deviations in subjective visual vertical following surgical repair (P =.37). The degree of audiometric air-bone gap normalized 6 weeks after surgery. Conclusions: All patients undergoing SCDS repair should undergo a postoperative fall risk assessment. Nystagmus direction (spontaneous and post-head-shaking) seems to be a good indicator of the degree of peripheral vestibular system involvement and central compensation. These measures correlate well with the HIT.
机译：目的：研究（1）上管开裂综合征（SCDS）手术修复后功能平衡的损害和恢复，以及（2）前庭功能障碍和生理补偿的程度。设计：前瞻性研究。地点：第三级转诊中心。参与者：30名被诊断患有SCDS的患者。干预措施：SCDS的外科手术插补和换肤。主要结果指标：在3个独立的组中评估了平衡指标，每个组有10位不同的患者：术前，术后短期（<1周）和术后长期（≥6周）。在10个患者的亚组中，对术后短期和长期阶段的前庭补偿和功能进行了评估，包括所有管平面中的定性头部冲激测试（HIT）和听力测量。结果：SCDS修复后立即平衡，但不是6周，平衡措施明显受损。在手术修复后，所有患者均表现出上管平面的前庭眼反射不足。出乎意料的是，大多数患者的自发性或摇头后眼球震颤在震颤中发生搏动，而仅在完全管壁麻痹的患者（即在所有管平面中HIT阳性）中才发现对搏性眼球震颤。手术修复后主观视觉垂直度无明显差异（P = .37）。术后6周听力测验的空气间隙水平恢复正常。结论：所有接受SCDS修复的患者均应接受术后跌倒风险评估。眼球震颤的方向（自发和摇头后）似乎是周围前庭系统受累程度和中枢补偿程度的良好指标。这些措施与HIT紧密相关。

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