突发性聋伴良性阵发性位置性眩晕病例分析并文献复习

发布时间：2019-05-26 23:19

【摘要】：目的:总结突发性聋(SSNHL)伴良性阵发性位置性眩晕(BPPV)患者的临床特点,探讨其可能的发病机制。方法:回顾性分析35例SSNHL伴有眩晕患者的临床资料,比较SSNHL伴BPPV组(9例)与SSNHL伴非BPPV组(26例)患者眩晕发病特点及听力治疗情况等临床特点。结果:SSNHL伴眩晕患者的听力损失较重,预后较差,听力损失治疗有效率为17.1%,显效率为11.4%,治愈率为5.7%。病史及体位试验检查,确诊BPPV的患者占SSNHL伴眩晕患者的25.7%,这些患者的听力损失较SSNHL伴非BPPV组听力损失更重。SSNHL伴发的BPPV多于SSNHL发病1周内出现(平均4.1d),常发生于全聋型患者(6例,占66.7%),其次为平坦下降型SSNHL患者(3例,占33.3%);所有患者的BPPV均发生于SSNHL受累的同侧耳,最常累及水平半规管(6例,占66.7%),其次为后半规管(3例,占33.3%),本组病例中未出现上半规管BPPV。SSNHL伴BPPV患者常需要多次复位治疗(平均2.3次),但复位后患者头晕症状缓解较快,后遗症状轻。结论:SSNHL伴BPPV发病率较高,常发生于重度听力损失患者中,且最常累及水平半规管,多次手法复位治疗有效。
[Abstract]:Objective: to summarize the clinical characteristics of (BPPV) patients with sudden deafness (SSNHL) with benign paroxysmal positional vertigo and to explore its possible pathogenesis. Methods: the clinical data of 35 patients with SSNHL with vertigo were analyzed retrospectively. the clinical features of vertigo and hearing therapy in SSNHL with BPPV group (n = 9) and SSNHL with non-BPPV group (n = 26) were compared. Results: the patients with SSNHL with dizziness had severe hearing loss and poor prognosis. The effective rate of hearing loss was 17.1%, the effective rate was 11.4%, and the cure rate was 5.7%. The medical history and posture test showed that the patients with BPPV accounted for 25.7% of the patients with SSNHL with dizziness. The hearing loss of these patients was more serious than that of SSNHL with non-BPPV group. SSNHL accompanied BPPV more than SSNHL within one week (average 4.1 days). It often occurred in patients with total deafness (6 cases, 66.7%), followed by flat descending SSNHL (3 cases, 33. 3%). BPPV occurred in the ipsilateral ear where SSNHL was involved, with the most common involvement in the horizontal semicircular canal (6 cases, 66.7%), followed by the posterior semicircular canal (3 cases, 33. 3%). In this group, patients with upper semicircular canal BPPV.SSNHL with BPPV often needed multiple reduction therapy (average 2.3 times), but after reduction, the dizziness symptoms relieved quickly and the sequelae were mild. Conclusion: the incidence of SSNHL with BPPV is high, which often occurs in patients with severe hearing loss, and the horizontal semicircular canal is the most common involved. Multiple manual reduction is effective.
【作者单位】：吉林大学第一医院耳鼻咽喉-头颈外科;
【基金】：国家自然科学基金资助课题(31540022)
【分类号】：R764.437

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