Bithermal caloric stimulation test in patients with possible and definite meniere's disease

การตรวจคาลอริกในผู้ป่วยโรคมีเนียร์

Name: Ratree Likhitamnuay

LCSH: Calorimetry

LCSH: Meniere's disease

Abstract: Meniere’s disease (MD) is a disorder of the inner ear associated with the presence of endolymphatic hydrops. At present there is no single test that makes the diagnosis of MD. Caloric test has been proven as useful in lateralizing the side of a vestibular lesion and in identifying disorders of the labyrinth and the vestibular nerve. The reports were not found in generally available collective literature studying the correlation between bithermal caloric stimulation test parameters and patients with possible, and definite MD. The purposes of this study were to study the caloric responses in patients with possible and definite MD, to compare the caloric responses between patients with possible and definite MD, and to study the relationship among caloric parameters and duration of disease in patients with possible and definite MD. In bithermal caloric test, each ear would be irrigated with water 125 cc.at 30oC and 44oC in all patients. Possible MD group consisted of 5 males and 25 females, definite MD group consisted of 14 males and 16 females. The mean ages, duration of disease, pure tone average (PTA) of right ears, PTA of left ears were 44.33 years, 4.40 years, 17.06 and 17.24 dBHL, respectively for possible MD group and 45.30 years, 5.19 years, 39.58 and 40.94 dBHL, respectively for definite MD group. Patients reported the functional level (at the level of 1, 2 and 3), tinnitus, aural fullness problems were 93.34%, 43.33% and 13.33% respectively for possible MD group and 93.33%, 93.33% and 53.33%, respectively for definite MD groups. The results for possible and definite MD group indicated that the means canal paresis (CP) and directional preponderance (DP) value showed no significant difference between right and left values. The maximum slow phase velocity (Vmax) showed no significant difference between the right and the left ears, the right and the left beats. The Vmax of irrigation revealed that the warm irrigation was significantly weaker response than the cool irrigation(p< 0.001). When comparing the results between both groups, the mean CP and DP values of patients with definite MD group were significantly higher than those in possible MD group (p< 0.05). No significant difference of mean Vmax for warm and cool water responses between both groups. No relationship between caloric findings and duration of disease in both groups. From the Vmax result, marked accentuation of the response to cold water irrigation was found in both groups. The reasons might be due to patients with MD having had a change of the central nervous system mechanism or the influence of pressure effects. The study of total CP and total DP indicators found that possible MD could represent a low functional impairment of the vestibular organ. This finding showed that patients with definite MD group might have more vestibular disturbance than possible MD group. From this study, the comparison intergroups should be interpreted by using direct Vmax combination with CP or DP indicators to make the diagnosis instead of the comparison by using the direct Vmax of warm or cool irrigation alone; bithermal caloric testing should be used as a test battery in clinical evaluations of definite MD and should be first conducted by warm water irrigation in order to reduce patients’ reaction to the test because of MD patients marked accentuation of the response to cold water irrigation.

Mahidol University

Address: NAKHON PATHOM

Email: liwww@mahidol.ac.th

Name: Chanchai Jariengprasert

Role: Thesis Advisors

Created: 2005

Modified: 2553-03-31

Issued: 2010-03-30

วิทยานิพนธ์/Thesis

application/pdf

ISBN: 9740457142

CallNumber: TH R236b 2005

eng

DegreeName: Master of Science

Level: Master's Degree

Descipline: Communication Disorders

Grantor: Mahidol University

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