大前庭水管综合征患者听力随访观察

发布时间：2018-10-30 12:27

【摘要】：目的动态观察大前庭水管综合征(large vestibular aqueduct syndrome,LVAS)患者的听力变化,为更好地保护LVAS患者的听力提供参考。方法选取2007年7月至2016年5月经确诊且资料完整、能够准确完成纯音听阈检测的双耳大前庭水管综合征患者21例为研究对象,年龄5~29岁,中位年龄11岁,其中男12例,女9例;12例患者行单侧人工耳蜗植入手术,另一耳佩戴助听器,其余患者均双耳佩戴助听器。动态观察非耳蜗植入耳听力2~7年,中位数3年4个月;在随访期间发现患者听力下降就诊,及时给予扩血管改善循环、营养神经等药物保守治疗1~2周,比较用药前后的听力变化;病情稳定者一年复查一次纯音听阈,动态观察听力变化。结果21例(30耳)中随访期间有15例发生过听力波动(下降),治疗前500、1 000、2 000、4 000 Hz平均纯音听阈分别为85.3±4.4、91.5±4.3、95.9±5.7、99.1±6.6dB HL,治疗后分别为66.5±4.1、74.4±4.1、76.8±5.0、80±5.9dB HL,各频率治疗前后比较差异均有统计学意义(均为P0.05)。结论大前庭水管综合征患者可表现为波动性或进行性感音神经性听力损失;早期发现、及时治疗,可使LVAS患者的听力维持在一定的水平或使之听力下降的速度明显减缓。
[Abstract]:Objective to observe the dynamic changes of hearing in patients with large vestibular aqueduct syndrome (large vestibular aqueduct syndrome,LVAS) and to provide reference for the better protection of the hearing of patients with large vestibular aqueduct syndrome (LVAS). Methods from July 2007 to May 2016, 21 patients with binaural great vestibular aqueduct syndrome who were diagnosed from July 2007 to May 2016 and whose data were complete accurately, including 12 males and 9 females, aged 529 years with a median age of 11 years, were selected. Unilateral cochlear implantation was performed in 12 patients, hearing aids were used in the other ear, and hearing aids were used in both ears. The hearing of non-cochlear implants was observed dynamically for 27 ~ 7 years, with a median of 3 years and 4 months. During the follow-up period, we found that the patients with hearing loss were treated with vasodilator to improve circulation and nutrition nerve for 1 to 2 weeks. The hearing changes before and after treatment were compared. The patients with stable condition rechecked the pure tone hearing threshold once a year and observed the change of hearing dynamically. Results during the follow-up period of 21 cases (30 ears), 15 cases had hearing fluctuation (decline). Before treatment, the mean pure tone hearing threshold was 85.3 卤4.4 卤94. 5 卤5. 799.1 卤5. 799.1 卤5. 799.1 Hz, respectively. After treatment, there were significant differences in the frequency of treatment (66.5 卤4.1) and 74.4 卤4.1 (76.8 卤5.0 卤80 卤5.9dB HL,) before and after treatment (P0.05). Conclusion the patients with large vestibular aqueduct syndrome may exhibit volatile or sensual hearing loss, and the early detection and timely treatment can significantly slow down the hearing loss or maintain a certain level of hearing in patients with LVAS.
【作者单位】：安徽省立医院耳鼻咽喉头颈外科;
【分类号】：R764

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