https://scholars.lib.ntu.edu.tw/handle/123456789/305745
標題: | Radiation-induced otitis media - Study of a new test, vestibular-evoked myogenic potential | 作者: | TSUNG-LIN YANG YI-HO YOUNG |
關鍵字: | Chronic otitis media; Radiation otitis media; Retrolabyrinthine lesion; Tapping evocation; Vestibular-evoked myogenic potential | 公開日期: | 2004 | 卷: | 60 | 期: | 1 | 起(迄)頁: | 295-301 | 來源出版物: | International Journal of Radiation Oncology Biology Physics | 摘要: | Purpose Excluding the radiation history, current physical examination and audiovestibular function tests fail to differentiate radiation-induced otitis media (ROM) from chronic otitis media (COM). This study applied the newly developed vestibular-evoked myogenic potential (VEMP) test to investigate whether the VEMP test can be of help in differentiating between them. Methods and materials Fourteen irradiated nasopharyngeal carcinoma (NPC) patients with ROM (18 ears) and 14 age-matched, and gender-matched patients with COM (18 ears) were enrolled. Each patient underwent stimulation with a short tone burst initially, and then by tapping the forehead using a tendon hammer. To define the effect of the neck soft tissue on the VEMP response further, an additional two groups (10 non-NPC patients with ROM but no neck fibrosis/edema and 10 non-NPC patients without ROM but with neck fibrosis/edema) were included for comparison. Results The occurrence of normal VEMPs in the ROM ears (33%) did not differ significantly from that in the COM ears (56%) by tone-burst stimulation. However, using tapping evocation, most (89%) COM ears revealed normal VEMPs, and most (61%) ROM ears demonstrated delayed VEMPs. Furthermore, most (90%) non-NPC patients with ROM but no neck fibrosis/edema revealed delayed or absent VEMPs. In contrast, all non-NPC patients with neck fibrosis/edema but no ROM demonstrated normal VEMPs bilaterally, implying that the effect of neck soft tissue on the VEMP response is less. Conclusion Through tapping evocation, most COM ears revealed normal VEMPs, and most ROM ears demonstrated delayed VEMPs, indicating that ROM is different from COM because of the larger affected areas such as retrolabyrinthine or brainstem involvement. This result can explain why grommet insertion or tympanoplasty is not beneficial to postirradiated ears, possibly because both operations spare the inflammation outside the middle ear cavity. ? 2004 Elsevier Inc. |
URI: | http://www.scopus.com/inward/record.url?eid=2-s2.0-4444252908&partnerID=MN8TOARS http://scholars.lib.ntu.edu.tw/handle/123456789/305745 |
DOI: | 10.1016/j.ijrobp.2004.02.033 | SDG/關鍵字: | Radiation induced otitis media (ROM); Soft tissues; Vestibular-evoked myogenic potential (VEMP); Computer simulation; Patient treatment; Radiation; Tissue; Biomedical engineering; adult; aged; article; chronic otitis media; clinical article; controlled study; edema; female; fibrosis; human; male; muscle excitation; muscle potential; muscle tone; nasopharynx carcinoma; otitis media; priority journal; statistical significance; vestibular system; Adolescent; Adult; Aged; Chronic Disease; Diagnosis, Differential; Ear, Middle; Evoked Potentials, Auditory; Female; Humans; Male; Middle Aged; Nasopharyngeal Neoplasms; Otitis Media; Radiation Injuries |
顯示於: | 醫學系 |
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