Avaliação vestibular dos pacientes com Doença de Ménière por meio da prova calórica e do Vídeo-Head Impulse Test

• Ano de defesa: 2019
• Autor(a) principal: Oliveira, Livia Noleto De Rezende [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Ménière Disease; Vertigo; Hearing Loss; Vestibular Functional Test; Doença De Ménière; Vertigem; Perda Auditiva; Testes De Função Vestibular
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=7728841; https://repositorio.unifesp.br/handle/11600/59643

Introduction: Ménière Disease (MD) is a labyrinthopathy that usually manifests with episodes of spontaneous vertigo associated with sensorineural hearing loss, tinnitus and aural fullness ipsilateral and unilateral in most cases. The tests of vestibular function, the video-head impulse test (vHIT) and caloric test (CT) are not specific for the disease, but may present changes that help to evaluate the functional impairment. Objective: To describe the results obtained for the CT and to vHIT in patients with MD and compares them between symptomatic and asymptomatic ears with the ears of the individuals in the control group. Method: Cross-sectional and observational study including patients with defined MD diagnosed according to the criteria of Bárány Society (2015) and healthy individuals (control group) submitted to the CT and to vHIT. All subjects were evaluated by means of otoneurological anamnesis, and audiological evaluation (tonal and vocal audiometry and imitanciometry) to characterize the sample. The findings obtained for CT and vHIT were described and compared between the symptomatic and asymptomatic ears of patients with DM and also those of the control group. Results: We evaluated 32 patients with defined MD, and the mean age of the patients was 45.7 years, the majority of females (68.8%) and unilateral. The control group consisted of 20 healthy individuals, with a mean age of 44.7 years and a female majority (70.0%). The groups were homogeneous in relation to age and sex. The main complaint was vertigo (71.9%), and the majority of patients had more than six attacks in the last six months. Moderate sensorineural hearing loss was present in 38.5% of the patients. The prevalence of hyporeflexia in PC was higher in the symptomatic (56.4%) and asymptomatic (36%) ears of DM patients when compared to the ears of the control group (7.5%), p <0.001 and p <0.001 = 0.004 respectively. VHIT changes in lateral CSCs were more frequent in the symptomatic ears of patients with DM than in the ears of controls, (p = 0.026). Conclusion: Most patients with defined DM presented hyporreflexia to PC and vHIT with normal function in the symptomatic ear. Vestibular hyporeflexia on PC was more frequent in the symptomatic and asymptomatic ears of patients with DM than in the ears of the control group. VHIT presented more changes in lateral CSC.