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Research in Vestibular Science 2011;10(4): 121-128. |
정상 온도안진검사를 보이는 어지럼 환자에서 전기안진검사, 회전의자검사, 동적자세검사를 통한 전정기능 상태의 새로운 분류법 제안 |
염혜연, 조양선, 홍성화, 정원호 |
성균관대학교 의과대학 삼성서울병원 이비인후-두경부외과학교실 |
New Proposal of Functional Status of Vestibular System Based on Vestibular Function Tests Findings in Dizzy Patients with Normal Caloric Response |
Hye Youn Youm, Yang Sun Cho, Sung Hwa Hong, Won Ho Chung |
Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. whchung@skku.edu |
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ABSTRACT |
Background and Objectives: Vestibular function tests are very useful in diagnosing dizzy patients. Among them, bithermal caloric test is most commonly used test for localizing their permanent vestibular loss. However, it causes much discomfort to the patients with non-physiologic stimuli. In addition, it doesn't represent the present functional status of vestibular system. Therefore, normal caloric result does not accurately correspond to normal vestibular function in dizzy patients. Currently, rotation chair test and dynamic posturography have been introduced adjunctly to assess vestibular function accompanied by bithermal caloric test. It has not been elucidated for their specific role in diverse settings of vestibular disorders. So we planned this study to evaluate clinical usefulness of rotation chair test, videonystagmography and computerized dynamic posturogr-phy in dizzy patients with normal caloric response. Materials and Methods: We reviewed clinical records of 46 patients who met their inclusion criteria. They were categorized into five subgroups according to abnormal vestibular function test findings. Results: In each subgroup, we hypothesized its clinical relevance, possible mechanism of dizz-iness and presumed diagnosis. Five categories are as below; visual dependency, imbalance of vestibular tones, chronic peripheral vestibulopathy, abnormality in the vestibulospinal tract and abnormality of oculomotor system. Conclusion: We suggest new classification of abnormal vestibular functional status in dizzy patients with normal caloric results. These are comparable according their clinical features and thought to be helpful in managing and counseling each patient. |
Keywords:
Normal caloric result; Rotation chair test; Videonystagmography; Computerized dynamic posturography; Visual dependency, Vestibular hyperactivity |
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