급성 일측말초전정마비 환자에서 혈관위험인자에 따른 청력 및 전정기능이상의 비교

Abstract

Background and Objectives: Etiology of acute unilateral peripheral vestibulopathy (AUPV) includes virus, ischemia, and autoimmune. As anatomical distribution is similar between vasculature and innervation, AUPV with vascular risk factors could be ischemic origin. We investigated the pattern of audiovestibular dysfunction to explore the influence of risk factors on AUPV. Materials and Methods: We collected records of 162 AUPV patients from 2011 to 2013 who were admitted within 7 days from vertigo onset and diagnosed as AUPV by caloric test and neuro-otologic examination. Vascular risk factors are stroke history, hypertension, diabetes, body mass index ＞25, age ＞60, and vertebrobasilar stenosis. Bedside examination includes spontaneous nystagmus grade, head impulse test, head shaking test. Results of rotatory chair test (n=125), caloric test (n=162), cervical (n=33) and ocular (n=23) vestibular evoked myogenic potential (VEMP), subjective visual vertical (SVV) (n=91), and pure tone audiometry (PTA) (n=62) are collected. Results: Abnormalities of PTA are found more in patients with vascular risk factor than without any risk factor. Specifically, hypertension (p=0.008) and old age (p=0.025) are associated with PTA abnormality (p=0.006). Tilt angle of vertical is larger in risk factor group (p=0.019). The number of vascular risk factor correlates with abnormalities of PTA (p=0.025) and tilt angle of SVV. Results of bedside examination, rotatory chair test, caloric test, cervical and ocular VEMP are not associated with vascular risk factors. Conclusion: AUPV patients with vascular risk factors have more extensive involvement of audiovestibular function. Ischemic etiology may contribute to pathogenesis of extensive AUPV.