Nystagmus in patients with unilateral acute otitis media complicated by serous labyrinthitis

<b>Conclusion</b> The patients with serous labyrinthitis caused by acute otitis media (AOM) exhibited various patterns of nystagmus in which direction-fixed irritative-type nystagmus was the most common pattern. Differential effects on inner ear function by toxic or inflammatory mediators may be responsible for the various manifestation of nystagmus. <b>Objective</b> This study aimed to investigate nystagmus patterns in patients with serous labyrinthitis, and discuss possible mechanisms. <b>Methods</b> From October 2011 to March 2014, 13 consecutive patients with serous labyrinthitis were included. Eye movements of the patients were serially examined using video-nystagmography, and patterns of nystagmus were investigated. <b>Results</b> The most commonly observed pattern was direction-fixed nystagmus (nine of 13 patients). Of these, eight showed irritative-type, and one showed paretic-type. Direction of nystagmus, although the intensity gradually decreased, was not changed during the course of treatment. One patient showed direction-changing spontaneous nystagmus, which changed into paretic-type direction-fixed nystagmus 1 day after myringotomy. Three patients exhibited persistent direction-changing positional nystagmus in a supine head-roll test. Of them, two showed apogeotropic and one showed geotropic type. In all 13 patients, vertigo and hearing loss were improved after the treatment.

<b>结论</b> 由急性中耳炎（acute otitis media, AOM）引发的浆液性迷路炎（serous labyrinthitis）患者可出现多种类型的眼震（nystagmus），其中以方向固定的刺激性眼震最为常见。毒性介质与炎性介质对内耳功能的差异性影响，可能是眼震表现多样的原因。
<b>研究目的</b> 本研究旨在探讨浆液性迷路炎患者的眼震类型，并分析其可能的发病机制。
<b>研究方法</b> 2011年10月至2014年3月，共纳入13例连续性浆液性迷路炎患者。采用视频眼震图（video-nystagmography）对患者的眼球运动进行连续检测，并对眼震类型展开分析。
<b>研究结果</b> 最常见的眼震类型为方向固定性眼震（13例患者中9例），其中8例为刺激性类型，1例为麻痹性类型。尽管眼震强度随治疗进程逐渐降低，但眼震方向在治疗期间未发生改变。1例患者表现为方向变换性自发性眼震，在鼓膜切开术（myringotomy）后1天转为麻痹性方向固定性眼震。3例患者在仰卧位头位变位试验（supine head-roll test）中表现出持续性方向变换性位置性眼震，其中2例为背地性（apogeotropic）类型，1例为向地性（geotropic）类型。所有13例患者的眩晕与听力损失症状均在治疗后得到改善。