继发于突发性聋的良性阵发性位置性眩晕的临床治疗分析

发布时间：2018-10-10 06:46

【摘要】：目的回顾性分析继发于突发性聋的良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)患者的临床表现,并探讨其可能的发病机制,探索合适的诊断与治疗方案。方法观察218例突发性聋患者中BPPV的发病情况和临床治疗效果,另有37例同期原发性BPPV作为对照组。所有患者均经Dix-Hallpike实验和Barbecue滚转检查确定诊断,继发性BPPV患者的原发病(突发性聋)符合中华医学会耳鼻咽喉头颈外科学分会制定的诊断标准。按照BPPV类型,进行Epley手法复位或Barbecue翻滚手法治疗,并评价治疗效果。结果218例突发性聋患者中有9l例出现BPPV,发生率41.7%,均为同侧患耳。BPPV经耳石复位,其中1次治愈62例(68.1%),2次治愈16例(17.6%),3次治愈13例(14.3%)。随访6~22个月,高频听力改善均不及低频,外半规管型BPPV复发2例,后半规管型复发5例,经过再次复位后治愈。继发性BPPV与原发性BPPV均经手法复位治愈,疗效相似。结论BPPV可继发于突发性聋,且突发性聋继发BPPV可达41.7%,其中以后半规管BPPV常见,耳石复位治疗是最为有效的治疗方法,治愈率与原发性BPPV相似。
[Abstract]:Objective to retrospectively analyze the clinical manifestations of benign paroxysmal positional vertigo (benign paroxysmal positional vertigo,BPPV) secondary to sudden deafness, and to explore the possible pathogenesis and appropriate diagnosis and treatment. Methods the incidence and clinical effect of BPPV were observed in 218 patients with sudden deafness, and 37 patients with primary BPPV were used as control group. All the patients were diagnosed by Dix-Hallpike test and Barbecue roll test. The primary disease (sudden deafness) of secondary BPPV patients was in accordance with the diagnostic criteria established by the Otolaryngology and head and neck surgery Society of the Chinese Medical Association. According to the type of BPPV, Epley manual reduction or Barbecue tumbling manipulation was performed, and the therapeutic effect was evaluated. Results among 218 patients with sudden deafness, the incidence of BPPV, was 41.7%. All of them were ipsilateral ear. BPPV was resected by otolith. Among them, 62 cases (68.1%) were cured once, 16 cases (17.6%) were cured twice, 13 cases (14.3%) were cured 3 times. Follow-up for 6 ~ 22 months showed that the improvement of high frequency hearing was less than that of low frequency. There were 2 cases of external semicircular BPPV recurrence and 5 cases of posterior semicircular canal recurrence. Secondary BPPV and primary BPPV were cured by manual reduction, and the curative effect was similar. Conclusion BPPV can be secondary to sudden deafness and sudden deafness secondary BPPV can reach 41.7 in which the secondary semicircular canal BPPV is common. Otolithiasis reduction is the most effective treatment method and the cure rate is similar to that of primary BPPV.
【作者单位】：延安市人民医院耳鼻咽喉头颈外科;
【分类号】：R764.437

【相似文献】