Koklear sinaptopati: VEMP sonuçlarının değerlendirilmesi
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Dosyalar
Tarih
2024
Yazarlar
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Yayıncı
İstanbul Gelişim Üniversitesi Lisansüstü Eğitim Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Koklear sinaptopati genellikle gürültü maruziyeti sonucu oluşan sinaptik bir hastalıktır. Gürültünün sadece işitsel sisteme değil, aynı zamanda sakkül başta olmak üzere vestibüler sisteme de zarar verdiği kanıtlanmıştır. Sakkül fonksiyonunu ölçebilen testlerin arasında VEMP testi en sık kullanılan testlerdendir. Bu çalışmanın amacı, koklear sinaptopatili hastalarda olası vestibüler bozuklukların VEMP aracılığı ile değerlendirilmesidir. Çalışmamıza Kastamonu Eğitim ve Araştırma Hastanesi Odyoloji Kliniği'ne gürültüde konuşmayı anlamama şikayeti ile başvuran, koklear sinaptopati tanısı alan hastalar dahil edilmiştir. Bu koklear sinaptopatili hasta grubuna VEMP testi uygulanmıştır. Test uygulanırken supin pozisyondaki hastalardan başlarını test edilen kulağın karşı yönüne çevirip yukarı kaldırmaları istenmiştir. Bu sayede yeterli sternokleidomastoid kasılımı sağlanmıştır. Elde edilen VEMP sonuçları; P1 latans, N1 latans, tepeler arası amplitüd, asimetri oranı, VEMP eşiği, VEMP cevabı varlığı ve VEMP cevabı durumu parametreleri kontrol grubu ile istatistiksel olarak kıyaslanmıştır. Yapılan karşılaştırmalarda gruplar arasında P1 latans, N1 latans, tepeler arası amplitüd, asimetri oranı ve VEMP eşiği parametrelerinde istatistiksel olarak anlamlı fark saptanmamıştır. VEMP cevabı varlığı karşılaştırıldığında, koklear sinaptopati grubunda VEMP cevabı alma oranının önemli ölçüde azaldığı tespit edilmiş ve istatistiksel olarak anlamlı bulunmuştur (P=0,034). Gruplar arasında VEMP cevabı durumu kıyaslandığında ise, koklear sinaptopati grubunda VEMP cevabı durumunda anormal VEMP sonuçları oranının arttığı gözlenmiş ve istatistiksel olarak anlamlı bulunmuştur (P=0,004). Koklear sinaptopatinin, başta sakküler fonksiyon bozukluğu olmak üzere vestibüler bozuklukluklar için risk faktörü olabileceği ve klinikte çalışan odyologların ve kulak burun ve boğaz uzmanlarının bu bozukluklarının erken tanı ve tedavisi için bilgilendirilmeleri açısından katkıda bulunulacağı düşünülmektedir. Bu amaçla klinikte koklear sinaptopati tanısı alan hastalara VEMP ile veya diğer test bataryaları ile vestibüler bozukluklar için tarama testleri uygulanabileceği, bu sayede vestibüler bozuklukların erken tanı ve tedavisi sağlanabileceği düşünülmektedir.
Cochlear synaptopathy is a synaptic disease that usually occurs as a result of noise exposure. It has been proven that noise damages not only the auditory system, but also the vestibular system, especially the saccule. Among the tests that can measure saccule function, the VEMP test is one of the most commonly used tests. The aim of this study is to evaluate possible vestibular disorders in patients with cochlear synaptopathy via VEMP. Patients diagnosed with cochlear synaptopathy who applied to Kastamonu Training and Research Hospital Audiology Clinic with difficulty understanding speech in noise were included in our study. VEMP testing was applied to patients with cochlear synaptopathy. During the test, patients in the supine position were asked to turn their heads to the opposite direction of the tested ear and lift them up. In this way, adequate sternocleidomastoid contraction was achieved. P1 latency, N1 latency, interpeak amplitude, asymmetry ratio, VEMP threshold, presence of VEMP response and VEMP response status parameters were compared with the control group. In the comparisons made, no statistically significant difference was detected between the groups in the P1 latency, N1 latency, interpeak amplitude, asymmetry ratio and VEMP threshold parameters. When the presence of VEMP response was compared, it was determined that the rate of VEMP response was significantly reduced in the cochlear synaptopathy group and was found to be statistically significant (P = 0.034). When VEMP response status was compared between the groups, it was observed that the rate of abnormal VEMP results increased in the case of VEMP response in the cochlear synaptopathy group and was found to be statistically significant (P = 0.004). It is thought that cochlear synaptopathy may be a risk factor for vestibular disorders, especially saccular dysfunction, and our study will contribute to informing audiologists, ear nose and throat specialists and other specialists working in clinics for the early diagnosis and treatment of these disorders. For this purpose, it is thought that screening tests for vestibular disorders can be applied to patients diagnosed with cochlear synaptopathy in the clinic, with VEMP or other test batteries, thus early diagnosis and treatment of vestibular disorders can be provided.
Cochlear synaptopathy is a synaptic disease that usually occurs as a result of noise exposure. It has been proven that noise damages not only the auditory system, but also the vestibular system, especially the saccule. Among the tests that can measure saccule function, the VEMP test is one of the most commonly used tests. The aim of this study is to evaluate possible vestibular disorders in patients with cochlear synaptopathy via VEMP. Patients diagnosed with cochlear synaptopathy who applied to Kastamonu Training and Research Hospital Audiology Clinic with difficulty understanding speech in noise were included in our study. VEMP testing was applied to patients with cochlear synaptopathy. During the test, patients in the supine position were asked to turn their heads to the opposite direction of the tested ear and lift them up. In this way, adequate sternocleidomastoid contraction was achieved. P1 latency, N1 latency, interpeak amplitude, asymmetry ratio, VEMP threshold, presence of VEMP response and VEMP response status parameters were compared with the control group. In the comparisons made, no statistically significant difference was detected between the groups in the P1 latency, N1 latency, interpeak amplitude, asymmetry ratio and VEMP threshold parameters. When the presence of VEMP response was compared, it was determined that the rate of VEMP response was significantly reduced in the cochlear synaptopathy group and was found to be statistically significant (P = 0.034). When VEMP response status was compared between the groups, it was observed that the rate of abnormal VEMP results increased in the case of VEMP response in the cochlear synaptopathy group and was found to be statistically significant (P = 0.004). It is thought that cochlear synaptopathy may be a risk factor for vestibular disorders, especially saccular dysfunction, and our study will contribute to informing audiologists, ear nose and throat specialists and other specialists working in clinics for the early diagnosis and treatment of these disorders. For this purpose, it is thought that screening tests for vestibular disorders can be applied to patients diagnosed with cochlear synaptopathy in the clinic, with VEMP or other test batteries, thus early diagnosis and treatment of vestibular disorders can be provided.
Açıklama
Danışman: DR. ÖĞR. ÜYESİ BAŞAK ÇAYPINAR ESER
Yer Bilgisi: İstanbul Gelişim Üniversitesi / Lisansüstü Eğitim Enstitüsü / Odyoloji Ana Bilim Dalı / Odyoloji Bilim Dalı
Konu: Kulak Burun ve Boğaz = Otorhinolaryngology (Ear-Nose-Throat)
Dizin: Postural denge = Postural balance ; Spatial denge = Spatial equilibrium ; Teşhis-kulak-burun-boğaz = Diagnosis-otorhinolaryngologic ; Uyarılmış potansiyeller-işitsel = Evoked potentials-auditory ; İç kulak = Ear-inner
Anahtar Kelimeler
Koklear sinaptopati, VEMP, gürültü, Cochlear synaptopathy, noise
