Kanıtlanmış Vestibüler ve İşitme Kaybı olan Meniere Hastalarında Supresyon Baş Savurma Paradigması (SHIMP) ve Video Baş Savurma Testinin (vHIT) Değerlendirilmesi

Year 2024, Volume: 46 Issue: 2, 228 - 235, 18.03.2024

Arzu Kırbaç Serpil Alluşoğlu Armağan İncesu Hülya Özen Ercan Kaya Mehmet Özgür Pınarbaşlı

https://doi.org/10.20515/otd.1373302

Abstract

Bu çalışmada, kesin Meniere hastalığı (MH) tanısı alan erişkinlerde video baş savurma testi (vHIT) ve supresyon baş savurma paradigması (SHIMP) sonuçlarının incelenmesi amaçlandı. Bu çalışma, tek taraflı kesin MH tanısı almış, semptomatik kulaklarında kanal parezi ve sensörinöral tip işitme kaybı olan 18-45 yaş arası 20 hasta ile yapıldı. Bireyler, geleneksel odyometri (0,125–8 kHz), bitermal binaural hava kalorik testi, vHIT ve SHIMP ile değerlendirildi. MH olan tarafın ortalama SHIMP vestibülo-oküler refleks (S-VOR) kazancı 0,69, sağlıklı tarafınki ise 0,77 idi. S-VOR kazanç değerleri her iki tarafta da ortalama vHIT VOR kazanç (V-VOR) değerlerinden istatistiksel olarak düşüktü (p<0,001). Anti-kompansatuar sakkad (AKS) latansı ve genliği ile S-VOR kazancı açısından MH olan ve sağlıklı taraf arasında anlamlı bir fark yoktu (p>0.05). MH olan kulakların; vHIT sonuçları %35'inde (7/20 kulak), SHIMP sonuçları ise %50'sinde (10/20 kulak) anormaldi. Sağlıklı tarafta ise kulakların %10'unda (2/20 kulak) vHIT sonuçları ve %35'inde (7/20 kulak) SHIMP sonuçları anormaldi. Bu çalışmada sonuç olarak V-VOR ve S-VOR kazançları, vHIT sakkadları, SHIMP sakkad latansı ve SHIMP sakkad amplitüdünün Meniere hastalarında etkilenen ve sağlıklı kulakları ayırt etmede faydalı parametreler olmadığı bulunmuştur. Yani beklenenin aksine, Meniere hastalığı’nda patolojik tutulumu tespit etmek için vHIT ve SHIMP testleri yeterli değildi.

Keywords

Meniere Hastalığı, İşitsel Kayıp, Vestibüler Kayıp, Supresyon Baş Savurma Paradigması, Video Baş Savurma Testi.

Ethical Statement

Ethics Committee Approval: The study was approved by Eskişehir Osmangazi University Noninterventional Clinical Research Ethical Committee (Decision no: 38, Date: 29.09.2020).

Evaluation of Suppression Head Impulse Paradigm (SHIMP) and the Video Head Impulse Test (vHIT) in Patients with Meniere’s disease with Proven Vestibular and Auditory Loss

Abstract

This study aimed to examine the results of the video head impulse test (vHIT), and suppression head impulse paradigm (SHIMP) in adult diagnosed with definite Meniere’s disease (MD). This study was conducted with 20 patients aged 18-45 years with canal paresis and sensorineural type hearing loss in symptomatic ears, who were diagnosed with unilateral definite MD. The subjects were assessed with conventional audiometry (0.125–8 kHz), the bithermal binaural air caloric test, vHIT, and SHIMP. The mean SHIMP vestibulo-ocular reflex (S-VOR) gain of the MD side was 0.69, and that of the healthy side was 0.77. The S-VOR gain values were statistically lower than the mean vHIT VOR gain (V-VOR) values on both sides (p<0.001). There was no significant difference between the MD and healthy sides in terms of the anti-compensatory saccades (ACSs) latency and amplitude and S-VOR gain (p>0.05). In the MD group, the vHIT results were abnormal in 35% (7/20 ears) of the ears, and the SHIMP results were abnormal in 50% (10/20 ears). On the healthy side, the vHIT results were abnormal in 10% (2/20 ears) of the ears, and the SHIMP results were abnormal in 35% (7/20 ears). In this study, the V-VOR and S-VOR gains, vHIT saccades, SHIMP saccade latency, and SHIMP saccade amplitude were not found to be beneficial parameters in differentiating affected and healthy ears in the patients with MD. In other words, contrary to expectations, vHIT and SHIMP tests were not sufficient to detect pathological involvement in Meniere's disease.

Keywords

Meniere’s Disease, Auditory Loss, Vestibular Loss, Suppression Head Impulse Paradigm, Video Head Impulse Test.

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