How much do you know about vestibular function?

Vestibular function plays a key role in the human body, and the vestibular center has a compensatory effect on vestibular damage. However, vestibular dysfunction can lead to a series of diseases. The first symptom is dizziness, followed by progressive hearing loss or trigeminal or glossopharyngeal neuralgia. When these diseases occur, it is likely that there is a problem with the vestibular function, so people need to regularly perform vestibular function tests to better analyze the cause. Vestibular function tests are basically distributed in otolaryngology and neurology, and vary depending on the hospital.

1. The importance of vestibular function

Statistics show that 70% of vertigo cases are caused by vestibular system diseases or diseases involving the vestibular system. Therefore, when a patient with vertigo sees a doctor, the first thing to consider is whether there is a problem with the vestibular system, and then do vestibular function tests and conduct a cause analysis. Vestibular function testing is performed in the otolaryngology department in most hospitals, and in the neurology department in some hospitals.

Because the vestibular center has a compensatory effect on vestibular damage, patients may not have symptoms of vertigo when vestibular damage is slowly progressive, such as acoustic neuroma and cholesteatoma in the brainstem; there may also be no obvious symptoms of vertigo when there is bilateral vestibular damage, so patients with tinnitus + progressive hearing loss, trigeminal or glossopharyngeal neuralgia (caused by cholesteatoma compression), or balance disorders in the dark should also undergo vestibular function testing.

2. Impact of vestibular dysfunction

Various diseases with vertigo as the main symptom can be divided into vestibular and non-vestibular types according to the site of the lesion. The former is more common clinically, and it is further divided into peripheral vestibular and central vestibular types. When vertigo originates from the vestibular receptors and vestibular nerves in the inner ear, it is called vestibular peripheral vertigo. Common diseases such as Meniere's disease, benign positional vertigo, vestibular neuronitis, labyrinthitis, ototoxic drug poisoning, etc. are mainly characterized by paroxysmal, rotational vertigo, which may also be a sense of swinging, floating, rising and falling, etc. At the same time, they have horizontal or horizontal rotational nystagmus and autonomic nervous system reactions (nausea, vomiting, cold sweats, etc.) consistent with the degree of vertigo, often accompanied by tinnitus and hearing loss. During an attack, the patient is conscious and the symptoms last from several minutes to several days. They usually ease within a few hours and rarely last more than a week. Central vestibular vertigo is caused by lesions of the vestibular nerve nuclei in the brainstem and the vestibular pathways above it, such as vertebral-basilar artery insufficiency, posterior cranial fossa brain tumors, etc., accounting for about 10%-20% of vertigo cases. Most of them are non-rotational vertigo, which is relatively mild in degree. There is usually no nausea or vomiting, or severe nausea or vomiting that is inconsistent with the degree of vertigo. There may be impaired consciousness and other signs of neurological damage. There are rarely cochlear symptoms, and the disease lasts for a long time and is a slow process. Non-vestibular vertigo, on the other hand, presents with obvious signs and symptoms of the primary disease, and is not difficult to distinguish clinically. Such as cervical spondylosis, refractive error, abnormal blood pressure, etc.

Vertigo mostly originates from the ear department, but also involves many departments such as neurology, internal medicine, ophthalmology, orthopedics, etc. The diagnosis and treatment process is complicated. If there is no comprehensive vertigo diagnosis and treatment center, different types of vertigo should be diagnosed and treated in the corresponding departments so that they can receive reasonable diagnosis and treatment in a shorter time and save money.