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ID 115938
タイトル別表記
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
著者
髙橋, 美香 徳島大学大学院医科学教育部(医学専攻)
戸田, 直紀 Tokushima University
中村, 克彦 Tokushima University
岩﨑, 英隆 Tokushima University
Miyoshi, Hitomi Tokushima University
キーワード
Ramsay Hunt syndrome
Varicella-zoster virus
Vestibular nerve
Cochlear nerve
Gd-enhanced MRI
資料タイプ
学位論文
抄録
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.
掲載誌名
Auris Nasus Larynx
ISSN
03858146
cat書誌ID
AA11522116
AA00061157
出版者
Oto-Rhino-Laryngological Society of Japan|Elsevier
48
3
開始ページ
347
終了ページ
352
発行日
2020-09-11
備考
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。
EDB ID
出版社版DOI
出版社版URL
フルテキストファイル
言語
eng
著者版フラグ
博士論文全文を含む
文科省報告番号
甲第3479号
学位記番号
甲医第1481号
学位授与年月日
2021-02-25
学位名
博士(医学)
学位授与機関
徳島大学
部局
医学系
病院