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ID 115938
Title Alternative
ラムゼイ・ハント症候群症例の前庭蝸牛神経MRI造影効果と前庭蝸牛機能障害との関係
Author
Takahashi, Mika Tokushima University
Toda, Naoki Tokushima University
Nakamura, Katsuhiko Tokushima University
Iwasaki, Hidetaka Tokushima University
Miyoshi, Hitomi Tokushima University
Abe, Koji Tokushima University KAKEN Search Researchers
Keywords
Ramsay Hunt syndrome
Varicella-zoster virus
Vestibular nerve
Cochlear nerve
Gd-enhanced MRI
Content Type
Thesis or Dissertation
Description
Objective: The correlation between enhancement of the vestibulocochlear nerves on gadolinium-enhanced magnetic resonance imaging (MRI) and vestibulocochlear functional deficits was examined in patients with Ramsay Hunt syndrome (RHS).
Methods: Nineteen patients with RHS who showed herpes zoster oticus, peripheral facial palsy, and vertigo were enrolled. Canal paresis (CP) in the caloric test, abnormal response to ocular and cervical vestibular myogenic potentials (oVEMP and cVEMP), and refractory sensorineural hearing loss were evaluated. MRI images perpendicular to the internal auditory canal were reconstructed to identify the superior (SVN) and inferior vestibular nerves (IVN) and the cochlear nerve (CV). The signal intensity increase (SIinc) of the four-nerve enhancement was calculated as an index.
Results: Among RHS patients, 79%, 53%, 17% and 26% showed CP in the caloric test, abnormal responses to oVEMP and cVEMP, and refractory sensorineural hearing loss, respectively. SIinc rates of the SVN were significantly increased in RHS patients with CP in the caloric test, and with abnormal responses to oVEMP and cVEMP. SIinc rates of the SVN tended to increase in RHS patients with refractory sensorineural hearing loss ( p = 0.052). SIinc rates of the IVN were significantly increased in RHS patients with abnormal responses to oVEMP and cVEMP, and refractory sensorineural hearing loss, but not in those with CP in the caloric test. SIinc rates of the CN were significantly increased in RHS patients with CP in the caloric test, abnormal response to oVEMP and refractory sensorineural hearing loss, but not in those with abnormal response to cVEMP.
Conclusion: In patients with RHS, the origin of vertigo may be superior vestibular neuritis, which is affected by reactive varicella-zoster virus from the geniculate ganglion of the facial nerve through the faciovestibular anastomosis. The results also suggested that in some RHS patients, inferior vestibular neuritis contributes to the development of vertigo and that the origin of refractory sensorineural hearing loss is cochlear neuritis.
Journal Title
Auris Nasus Larynx
ISSN
03858146
NCID
AA11522116
AA00061157
Publisher
Oto-Rhino-Laryngological Society of Japan|Elsevier
Volume
48
Issue
3
Start Page
347
End Page
352
Published Date
2020-09-11
Remark
内容要旨・審査要旨・論文本文の公開
本論文は,著者Mika Takahashiの学位論文として提出され,学位審査・授与の対象となっている。
DOI (Published Version)
URL ( Publisher's Version )
FullText File
language
eng
TextVersion
ETD
MEXT report number
甲第3479号
Diploma Number
甲医第1481号
Granted Date
2021-02-25
Degree Name
Doctor of Medical Science
Grantor
Tokushima University
departments
Medical Sciences
University Hospital