听神经瘤的耳科表现与肿瘤性质的相关性研究

发布时间：2018-01-04 04:07

  本文关键词：听神经瘤的耳科表现与肿瘤性质的相关性研究　出处：《重庆医科大学》2015年硕士论文　论文类型：学位论文

  更多相关文章： 听神经瘤 听力下降 纯音测听 听性脑干反应 囊性变

【摘要】：目的：描述听力学检查在听神经瘤诊断的作用,并探讨其和肿瘤的囊实性相关性。方法：纳入2004年1月-2015年1月重庆医科大学第二附属医院耳鼻咽喉头颈外科、神经外科诊断的听神经瘤共57例。分析听神经瘤中临床表现、纯音听阈、言语识别率、声导抗(鼓室图、镫骨肌反射)、畸变耳声发射、听性脑干反应的表现。根据脑MRI或术中肿瘤内的囊性变分为囊性瘤和实性瘤,分析肿瘤囊性变和肿瘤大小、位置及年龄、性别、临床表现和听力学检查的相关性。结果：听神经瘤的最常见症状包括听力下降(84.21%)、耳鸣(52.63%)、眩晕(31.58%)、颅神经损伤症状(17.54%)。纯音听阈表现为下降型(36.84%)、平坦型(28.07%),PTA64.24±21.67dB、SDS 36.37±28.04%, DPOAE正常有74.07%。镫骨肌反射和ABR阳性分别80.49%、94.73%,联合检查的阳性率98.25%。囊性瘤呈现的瘤体更大、多位于内听道外肿瘤(P=0.009),囊性瘤的颅脑神经损伤症状更多(P=0.044)。囊性瘤的PTA更差(P=0.014),但是SDS无显著差异,囊实性瘤听觉脑干诱发电位的潜伏期Ⅰ、Ⅲ、Ⅴ,潜伏间期Ⅰ-Ⅲ、Ⅰ-Ⅴ、 Ⅲ-Ⅴ,耳间差ILDV无显著差异。囊性变的在ILDV(Ⅰ-Ⅴ)对侧Ⅲ-Ⅴ/Ⅰ-Ⅲ更大(P=0.011、P=0.025)。结论：首诊有听力下降、耳鸣、眩晕表现的患者,均应进行PTA、 SDS.镫骨肌反射、DPOAE、ABR检查,当PTA和SDS显著差异,DPOAE正常、镫骨肌反射阳性、ABR阳性考虑蜗后病变者,需行脑MRI检查明确诊断。听神经瘤出现VIII颅神经外的神经症状,肿瘤多有囊性变,多是位于内听道外的大型肿瘤,PTA更差,ABR的ILD(Ⅰ-Ⅴ)、对侧IPL(Ⅲ-Ⅴ/Ⅰ-Ⅲ)异常延长。
[Abstract]:Objective: to describe the audiological examination in the diagnosis of acoustic neuroma, and explore the correlation of cystic and tumors. Methods: a total of Otolaryngology Head and neck surgery, January 2004 -2015 year in January in the Second Affiliated Hospital of Medical University Of Chongqing, Department of Neurosurgery diagnosis of acoustic neuroma in 57 cases. Analysis of acoustic neuroma in clinical manifestations, pure tone audiometry, speech recognition, voice immittance (tympanogram stapedius reflex), distortion otoacoustic emission, auditory brainstem response performance. According to the brain MRI or cystic tumor in variational cystic tumor and solid tumor, analysis of tumor cystic degeneration and tumor size, location and age, sex, clinical manifestations and correlation audiological examination. Results: listen to the most common symptoms of neuroma include hearing loss (84.21%), tinnitus (52.63%), vertigo (31.58%), the symptoms of cranial nerve injury (17.54%). Pure tone audiometry showed decreased type (36.84%), flat type (28.07%), P TA64.24卤21.67dB,SDS 36.37卤28.04%, DPOAE姝ｅ父鏈，

本文编号：1376953