| ObjectiveVestibular compensation is the process of vertigo, nausea and vomiting, balance disorders, spontaneous nystagmus and other clinical symptoms that caused by unilateral vestibular hypofunction disappeared, which could be divided into two stages of static and dynamic compensation. Subjective visual vertical / subjective visual horizontal(SVV/SVH) was an indicator to assess the function of the vestibular-ocular reflex, reflecting the tension on both sides of the vestibular system static equilibrium. This study was further improve the subjective visual evaluation in the acute peripheral unilateral vestibular dysfunction patients on the basis of commom conventional vestibular function evaluation routine. Then qualitative and quantitative analysis the characteristics of SVV/SVH and its relationships between conventional vestibular compensation indexes in patients with the acute peripheral unilateral vestibular hypofunction, in order to further explore the clinical value of SVV/SVH in vestibular function and compensation assessment, provide guidance basis for aspects of the vestibular system functional assessment, vertigo diagnosis and treatment and vestibular rehabilitation. Methods94 patients(female 51, male 43) who visited the balance center from March 2014 to May 2015 with acute peripheral unilateral vestibular dysfunction were enrolled as case group, including 69 with sudden deafness with vertigo,16 with vestibular neuritis and 9 with Hunt's syndrome. All patients were accepted related imageology, audiology and cerebral vascular Doppler and other detection exclude central lesions, and within 31 days from onset to treatment. Meanwhile,49 healthy volunteers(female 28, male 21)who accepted examinations at the same period were enrolled as control group, which required normal vision, no dizziness, balance disorders and ear or neurology else relevant medical history. Case group were performed with SVV/SVH, Spontaneous nytagmus(SN) and Caloric test(CT) by Video-Nytagmography(VNG Synapsys, French),Control group accepted SVV/SVH only. The angle of SVV and SVH, the intensity of SN, directional preponderance(DP), unilateral weakness(UW) of CT and duration were selected as the assessment indicators. The characteristics and relationships between all parameters were investigated respectively. Results1. SVV / SVH in control group and all parameters in case group showed a normal distribution. The skew angle of SVV, SVH in control group were between-1.5°~ 2.0°,-2.0°~ 1.6°, mean were 0.9 ± 0.6°,0.7 ± 0.6°respectively, so the study selected-2.0°~ 2.0°as the normal reference range of subjective visual gravity. Of the 94 patients, absolute value of the skew angle of SVV, SVH in the range between 2.1°~ 20.0°, 2.1°~ 22.2°,with mean were 4.3 ± 4.2°,4.4 ± 4.3°respectively. There was statistical difference between SVV/SVH in these two groups.2. In case group, positive frequency of SVV/SVH?SN?DP and UW were 58(61.7%)?53(56.4%)?32(34.0%)?64(68.1%) and 73(77.7%) respectively, four parameters were positive in 25 cases(26.6%), with statistical significance between the positive rate(allover?2 = 41.611, P = 0.000).3. In patients, there were positive correlation among SVV?SVH?SN and DP(r were 0.880, 0.509, 0.578, 0.454, 0.387, 0.634, all P = 0.000); SN, DP was negatively correlated with the duration(rswere- 0.264,-0.279, P <0.01). According to three parameters were positive or negative, three main types could be defined in 73 cases(77.7%)(SN+DP+UW+, SN-DP+UW+ and SN-DP-UW+),with median duration of 5d, 8d and 14 d respectively, which had statistical significance(?2=8.235, P=0.016);The skew angle of SVV,SVH was statistical significance in overall among the above three types(F was 13.973,12.449 respectively, P=0.000). ConclusionSubjective visual gravity can be used not only to assess the range of unilateral peripheral vestibular dysfunction, but also help assess the static compensatory of otolithic, guidance and assessment of vestibular rehabilitation. |
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