Effects of Saccular Function on Recovery of Subjective Dizziness After Vestibular Rehabilitation

被引:15
作者
Jeong, Junhui [1 ,2 ]
Jung, Jinsei [3 ]
Lee, Jeon Mi [4 ]
Suh, Michelle J. [3 ]
Kwak, Sang Hyun [3 ]
Kim, Sung Huhn [3 ,5 ]
机构
[1] Natl Hlth Insurance Serv Ilsan Hosp, Dept Otorhinolaryngol, Goyang, South Korea
[2] Yonsei Univ, Grad Sch, Dept Med, Seoul, South Korea
[3] Yonsei Univ, Coll Med, Dept Otorhinolaryngol, 50-1 Yonsei Ro, Seoul 03722, South Korea
[4] Inje Univ, Coll Med, Ilsan Paik Hosp, Dept Otorhinolaryngol, Goyang, South Korea
[5] Yonsei Univ, Coll Med, Airway Mucus Inst, Seoul, South Korea
关键词
Saccule; Vestibular neuritis; Vestibular rehabilitation; Vestibular-evoked myogenic potential; COMPENSATION; DYSFUNCTION; NEURITIS; STANCE; TASKS;
D O I
10.1097/MAO.0000000000001467
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: We attempted to investigate whether the integrity of saccular function influences the severity of subjective dizziness after vestibular rehabilitation in vestibular neuritis. Study Design: Retrospective analysis. Setting: Tertiary referral center. Patients: Forty-six patients with acute unilateral vestibular neuritis were included. Interventions: Diagnostic, therapeutic, and rehabilitative. Main Outcome Measures: All the patients completed vestibular rehabilitation therapy until their computerized dynamic posturography and rotary chair test results were significantly improved. The rehabilitation patients were classified into the normal to mild subjective dizziness and moderate to severe subjective dizziness groups according to the dizziness handicap inventory score (cutoff of 40). Differences between the two groups were analyzed. Results: After rehabilitation, 32.6% of the patients still complained of moderate to severe dizziness. Age, sex distribution, the presence of comorbidities, caloric weakness, pre- and postrehabilitation gain values in rotary chair test, postrehabilitation composite scores in posturography, and the duration of rehabilitation were not significantly different between the two groups. However, initial dizziness handicap inventory (DHI) score and composite score in dynamic posturography were worse and the proportion of patients with absent cervical vestibular-evoked myogenic potential in the moderate to severe group was much higher (93.3% vs. 35.5%, p < 0.001). After multiple regression analysis of those factors, initial DHI score and absent cervical vestibularevoked myogenic potential response were identified as being associated with higher postrehabilitation DHI score. Conclusion: Saccular dysfunction in acute vestibular neuritis can contribute to persistent subjective dizziness, even after the objective parameters of vestibular function tests have been improved by vestibular rehabilitation.
引用
收藏
页码:1017 / 1023
页数:7
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