Herediter anjioödem hastalarının odyolojik ve vestibüler bulgularının değerlendirilmesi
Yükleniyor...
Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Herediter anjioödem (HAE), otozomal dominant geçişli nadir bir
genetik hastalıktır. Literatürde HAE’nin odyo-vestibüler fonksiyonlarının üzerine
etkisi araştırılmamış olup mevcut çalışmada herediter anjioödem hastalığının odyovestibüler
fonksiyonlarının değerlendirilmesi amaçlandı.
Yöntem: Çalışmaya 20 herediter anjioödem hasta ve 20 sağlıklı kontrol grubu
dahil edildi. Her iki gruba otoendoskopik muayenesi ve katılımcılara araştırma
verilerinin elde edilmesinde sosyo-demografik özelliklerinin kaydedileceği anket
formu, saf ses odyometresi, kalorik test, Video Head Impulse Test (VHIT) ve
komputerize dinamik posturografi (KDP) testleri ve baş dönmesi engellilik envanteri
(BEE) uygulandı.
Bulgular: Çalışmaya dahil edilen HAE hastaların 11(%55)’i, kontrol
grubunun ise 12 (%60)’si kadındı. Hasta ve kontrol grubunda yaş ve cinsiyet dağılımı
istatistiksel olarak benzer bulundu (p>0,05). Hastaların hava ve kemik yolu işitme
seviye ölçümlerinden 2000 Hz ölçümleri dışındaki (500, 1000 ve 4000 Hz)
ölçümlerde, hasta grubu işitme seviyesi kontrol grubuna kıyasla anlamlı düzeyde
düşük tespit edildi (p<0,005). Kalorik testte hasta grubunda 9 (%45) hastanın kanal
parezisi saptandı, kontrol grubunda ise kanal parezisi saptanmadı. İstatiksel olarak
hasta grubunda kanal parezisi kontrol grubuna göre anlamlı düzeyde yüksek tespit
edildi. Maksimum yavaş phase velocity (MSPV) parametresi hasta grubunda kontrol
grubuna göre düşük belirlendi (p=0,023). VHIT’te hasta grubunda 6 (%30) hastada
vestibulo-ocular refleks (VOR) kazanç kaybı görüldü. Ayrıca 11 (%55) hastada
patolojik sakkad (covert,overt) izlendi. Kontrol grubunda ise VOR kazanç kaybı ve
patolojik sakkad hiç izlenmedi. İstatiksel olarak VOR kazancı hasta grubun sol anterior
(LA) ve sol lateral kanal (LL)’larında, kontrol grubuna göre istatistiki olarak anlamlı
düzeyde düşük belirlendi (p değerleri sırasıyla; p=0,035; p=0,006). KDP sonuçları
incelendiğinde hasta grubunda, kontrol grubuna göre Visual (AP), VES (AP), PREF
(AP), Global (AP), Visual (ML), VES (ML), PREF (ML), Global (ML) parametreleri
istatistiki olarak anlamlı düzeyde düşük belirlendi (p<0,001). BEE’de hasta grubunun
7 (%35)’inde dizziness handikap izlendi; birinde (%5) hafif ve 6’sında (%30) orta
derece handikap izlendi. Buna karşın kontrol grubunu bireylerinde dizziness handikap
izlenmedi.
Sonuç: Bu çalışmamız, HAE hastalarının odyo-vestibüler sistemin
değerlendirilmesini gerçekleştiren literatürdeki ilk çalışmadır. HAE hastalarının odyovestibüler
sistemlerinin etkilendiği objektif ve subjektif değerlendirmelerle ortaya
konmaktadır. Bu hasta grubu baş dönmesi şikayetleri ile kliniklere başvurabileceği ve
ilk tanı anında dahi olabileceği bilinmelidir. Ek olarak bu hastalara yönelik spesifik
vestibüler rehabilitasyon programları uygulanabilir ve hastaların vestibüler
fonksiyonları düzenli aralıklarla takip edilmesi gerekmektedir.
Objective: Hereditary angioedema (HAE) is a rare genetic disorder with autosomal dominant inheritance. In the literature, the impact of HAE on audiovestibular functions has not been investigated. This study aimed to evaluate the audiovestibular functions in patients with hereditary angioedema. Method: The study included 20 patients with hereditary angioedema and 20 healthy control subjects. Both groups underwent otoendoscopic examination and completed a questionnaire to record socio-demographic characteristics. Additionally, pure tone audiometry, caloric test, Video Head Impulse Test (VHIT), computerized dynamic posturography (CDP), and the dizziness handicap inventory (DHI) were administered to the participants to obtain research data. Results: Of the HAE patients included in the study, 11 (55%) were female, while 12 (60%) of the control group were female. The age and gender distribution in both the patient and control groups were found to be statistically similar (p>0.05). In the hearing level measurements of air and bone conduction, except for the 2000 Hz measurements, the patient group's hearing levels were significantly lower compared to the control group at 500, 1000, and 4000 Hz (p<0.005). In the caloric test, canal paresis was detected in 9 (45%) patients in the patient group, whereas no canal paresis was found in the control group. Statistically, canal paresis was significantly higher in the patient group compared to the control group. The maximum slow phase velocity (MSPV) parameter was found to be lower in the patient group compared to the control group (p=0.023). In the VHIT, vestibulo-ocular reflex (VOR) gain loss was observed in 6 (30%) patients in the patient group. Additionally, pathological saccades (covert and overt) were observed in 11 (55%) patients. The presence of VOR gain loss and pathological saccades in the patient group was statistically significant compared to the control group. In the control group, no VOR gain loss or pathological saccades were observed. Statistically, VOR gain was significantly lower in the left anterior (LA) and left lateral (LL) canals of the patient group compared to the control group (p values: p=0.035; p=0.006, respectively). When examining the CDP results, the Visual (AP), VES (AP), PREF (AP), Global (AP), Visual (ML), VES (ML), PREF (ML), and Global (ML) parameters in the patient group were found to be significantly lower compared to the control group (p<0.001). In the DHI, dizziness handicap was observed in 7 (35%) patients in the patient group; mild in 1 (5%) and moderate in 6 (30%). In contrast, no dizziness handicap was observed in the control group Conclusion: This study is the first in the literature to evaluate the audiovestibular system in patients with HAE. It demonstrates that the audio-vestibular systems of HAE patients are affected through objective and subjective assessments. It should be known that this patient group may present to clinics with complaints of dizziness, even at the time of initial diagnosis. Additionally, specific vestibular rehabilitation programs can be applied to these patients, and their vestibular functions should be regularly monitored.
Objective: Hereditary angioedema (HAE) is a rare genetic disorder with autosomal dominant inheritance. In the literature, the impact of HAE on audiovestibular functions has not been investigated. This study aimed to evaluate the audiovestibular functions in patients with hereditary angioedema. Method: The study included 20 patients with hereditary angioedema and 20 healthy control subjects. Both groups underwent otoendoscopic examination and completed a questionnaire to record socio-demographic characteristics. Additionally, pure tone audiometry, caloric test, Video Head Impulse Test (VHIT), computerized dynamic posturography (CDP), and the dizziness handicap inventory (DHI) were administered to the participants to obtain research data. Results: Of the HAE patients included in the study, 11 (55%) were female, while 12 (60%) of the control group were female. The age and gender distribution in both the patient and control groups were found to be statistically similar (p>0.05). In the hearing level measurements of air and bone conduction, except for the 2000 Hz measurements, the patient group's hearing levels were significantly lower compared to the control group at 500, 1000, and 4000 Hz (p<0.005). In the caloric test, canal paresis was detected in 9 (45%) patients in the patient group, whereas no canal paresis was found in the control group. Statistically, canal paresis was significantly higher in the patient group compared to the control group. The maximum slow phase velocity (MSPV) parameter was found to be lower in the patient group compared to the control group (p=0.023). In the VHIT, vestibulo-ocular reflex (VOR) gain loss was observed in 6 (30%) patients in the patient group. Additionally, pathological saccades (covert and overt) were observed in 11 (55%) patients. The presence of VOR gain loss and pathological saccades in the patient group was statistically significant compared to the control group. In the control group, no VOR gain loss or pathological saccades were observed. Statistically, VOR gain was significantly lower in the left anterior (LA) and left lateral (LL) canals of the patient group compared to the control group (p values: p=0.035; p=0.006, respectively). When examining the CDP results, the Visual (AP), VES (AP), PREF (AP), Global (AP), Visual (ML), VES (ML), PREF (ML), and Global (ML) parameters in the patient group were found to be significantly lower compared to the control group (p<0.001). In the DHI, dizziness handicap was observed in 7 (35%) patients in the patient group; mild in 1 (5%) and moderate in 6 (30%). In contrast, no dizziness handicap was observed in the control group Conclusion: This study is the first in the literature to evaluate the audiovestibular system in patients with HAE. It demonstrates that the audio-vestibular systems of HAE patients are affected through objective and subjective assessments. It should be known that this patient group may present to clinics with complaints of dizziness, even at the time of initial diagnosis. Additionally, specific vestibular rehabilitation programs can be applied to these patients, and their vestibular functions should be regularly monitored.
Açıklama
Anahtar Kelimeler
Herediter anjioödem, Hereditary angioedema, VHIT, Kalorik test, caloric test, Posturografi, posturography, BEE., DHI
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Afifoğlu, M. (2024). Herediter anjioödem hastalarının odyolojik ve vestibüler bulgularının değerlendirilmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Tıp Fakültesi Cerrahi Tıp Bilimleri Bölümü Kulak Burun Boğaz Hastalıkları Anabilim Dalı, Konya.
