摘要
Abstract
Objective To report changes in inner ear MRI before and after virtual reality vestibular rehabilitation therapy in patients with sudden deafness with vertigo,as well as factors that can influence treatment outcomes.Methods Patients with sudden deafness accompanied by dizziness admitted to our hospital from April 2022 to August 2024(n=111)were divided into a control group(routine therapies,n=59)and a study group(virtual reality therapies,n=52)based on the vestibular rehabilitation therapy modality they chose,with 41 patients in each propensity score matching(PSM)group.Hospital Anxiety and Depression Scale(HADS)and Dizziness Handicap Inventory(DHI)scores,and the cochlea/medulla oblongata(CM)ratio on inner ear MRI were compared between the two groups and before and after treatment using ANOVA.Factors influencing treatment efficacy were analyzed using generalized estimation equations.Results After 7 and 14 days of treatment,all HADS scores were lower than before treatment in both groups(P<0.05).Therapy modality and time after treatment were main influencing factors on DHI-F,DHI-E,DHI-P and total DHI scores,and on the CM ratio(P<0.05).After 14 days of treatment,all DHI scores and the CM ratio in the study group were also lower compared with the control group(P<0.05).The CM ratio was correlated to DHI-F,DHI-E,DHI-P and total DHI scores(P<0.05).Age,disease course,CM ratio,severity of hearing loss and hearing loss pattern affected clinical outcomes in these patients(P<0.05).For predicting treatment outcomes,the ROC curve showed the highest Yodene index at 0.610 when the CM ratio was 2.20,with corresponding sensitivity and specificity at 0.806 and 0.804,respectively,and an area under the ROC curve of 0.848,indicating certain values of the CM ratio in predicting treatment efficacy for sudden deafness with vertigo.Conclusions Compared with conventional rehabilitation therapies,vestibular rehabilitation assisted by virtual reality can significantly improve vertigo symptom outcomes with better treatment efficacy in patients with sudden deafness and vertigo.It can significantly reduce the CM ratio,probably by improving function of the blood-labyrinth barrier,which can be used to predict clinical outcomes.关键词
突发性聋伴眩晕/虚拟现实/前庭康复治疗/磁共振成像Key words
sudden deafness with vertigo/virtual reality/vestibular rehabilitation/magnetic resonance imaging
