Contralateral suppression of otoacoustic emissions in migraine patients without vestibular involvement

Amaç: Bu çalışmanın amacı duyusal modülasyon bozukluğuna yol açan migren hastalığı olan kişilerde işitme sistemi refleksi ölçümünde kullanılan bir test olan kontralateral otoakustik süpresyon testinin sonuçlarının değerlendirilmesidir. Yöntem: Çalışmaya nöroloji polikliniğine başvuran, Uluslararası Başağrısı Derneği'nin 2004 yılı kriterlerine göre migren tanısı alan ve vestibüler şikayeti olmayan gönüllü migren hastaları ve sağlıklı gönüllüler dahil edildi. Bütün gönüllülere tam otolojik muayene, saf ses odyometri testi yapıldı. Bilateral otoakustik emisyon yanıtı alınan 30 gönüllü migren hastası ve karşılaştırma için yaş ve cinsiyet özellikleri gönüllü hasta grubuna benzeyen 30 sağlıklı gönüllü çalışmaya dahil edildi. Çalışmaya dahil edilen gönüllülere kontralateral 50 dB SPL geniş bant gürültü ile maske yapılarak 65 dB click uyaran ile maskeli ve maskesiz otoakustik emisyon ölçümleri yapıldı. Her iki gruptan elde edilen veriler karşılaştırıldı. Bulgular: Sağlıklı gönüllülerin değerlendirilen 60 kulağının 40'ında (%67) süpresyon testi pozitif olarak tespit edilirken migren hastalarının değerlendirilen 60 kulağından 30'unda (%50) süpresyon testi pozitif olarak tespit edildi. Fakat süpresyon pozitifliği oranlarında ve süpresyon emisyon değerlerinde istatistiksel olarak anlamlı bir fark izlenmedi. İki grup arasında istatistiksel olarak anlamlı bir fark olmasa da migrenli grupta kontralateral supresyon cevaplarında azalma izlendi. Sonuç: Vestibüler şikayeti olmayan migren hastalarında normal kişilerle karşılaştırıldığında istatistiksel olarak anlamlı olmasa da kontralateral süpresyon cevaplarında bir azalma izlenmektedir. Daha büyük seri içeren yeni çalışmalar ile kontralateral otoakustik emisyon testi vestibüler şikayeti olmayan migren hastalarında odyovestibüler şikayetlerin erken tanısında kullanabileceği kanaatindeyiz.

Vestibüler şikayeti olmayan migren hastalarında kontralateral otoakustik emisyon süpresyonu

Objective: Our aim was to investigate contralateral suppression of otoacoustic emission for the evaluation of auditory reflex in patients with migraine which is a disease that may cause dysfunction of sensorial modulation. Methods: Voluntary migraine patients without vestibular symptoms who consulted to Neurology Clinic, and diagnosed according to the IHS 2004 criteria, and healthy volunteers were included in the study. All volunteers underwent complete otorhinolaryngologic and pure-tone audiometric examinations. Thirty voluntary migraine patients with bilateral otoacoustic emission measurements, and 30 healthy volunteers matched in terms of age and sex were included in the study. Otoacoustic emission measurements were obtained with 65 dB SPL click stimulus with and without mask by masking with contralateral 50 dB SPL broad band noise. Responses were compared between two groups. Results: Positive result was obtained in suppression tests in 40 of 60 (67%) ears of healthy volunteers and in 30 of 60 (50%) ears of migraine patients. However, there was no statistically significant difference between groups regarding positive suppression frequency and suppression values. Even though a statistically significant difference between migraine patients without vestibular involvement and control group was not seen, there was a decrease in contralateral suppression responses in the migraine group. Conclusion: Although it is statistically insignificant, we have demonstrated that migraine patients without vestibular symptoms showed a decrease in the suppression values compared to the healthy volunteers. We believe that in new studies with larger series, contralateral otoacoustic emission suppression test can be used as an early tool to diagnose audiovestibular symptoms in migraine patients without any vestibular involvement.

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ENT Updates-Cover
  • ISSN: 2149-7109
  • Başlangıç: 2015
  • Yayıncı: Prof.Dr.Murat Demir
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