耳鸣中枢化机制与临床诊疗

发布时间：2018-03-04 15:35

本文选题：耳鸣　切入点：听觉中枢　出处：《临床耳鼻咽喉头颈外科杂志》2014年04期 　论文类型：期刊论文

【摘要】：耳鸣是耳科临床最常见的病症之一,其确切机制尚不明确,普遍认为耳鸣是由耳蜗病变的异常活动导致或触发的,然而,对慢性顽固性耳鸣耳蜗(外周)机制很难解释持续产生的耳鸣感觉。本文提出耳鸣中枢化机制:源于外周听觉系统损伤后导致异常神经活动对中枢的长期刺激(包括耳鸣的刺激),被中枢界定为不良刺激,由于听觉中枢可塑性的存在,因而,外周异常信号输入后,中枢首先要对外周输入信号进行适应,中枢为了适应这些不良刺激,在对不良刺激活动产生适应性变化过程中,可能导致相应的神经元的突触活动异常,最终逐渐引起大脑皮层某些区域(如听皮层)突触超微结构的改变并出现功能重组,这种可塑性变化可能使耳鸣持续存在,导致耳鸣源于耳蜗而存在于中枢,即耳鸣被逐渐中枢化。文中最后阐述并讨论了基于耳鸣中枢化机制的临床耳鸣诊治。
[Abstract]:Tinnitus is one of the most common diseases in tinnitus. The exact mechanism of tinnitus is still unclear. It is generally believed that tinnitus is caused or triggered by abnormal activity of cochlear lesions. It is difficult to explain the persistent tinnitus sensation in the cochlea (peripheral) mechanism of chronic obstinate tinnitus. Including tinnitus stimulation, which is defined as a bad stimulus by the center, Because of the plasticity of the auditory center, after the peripheral abnormal signal is inputted, the center first has to adapt to the peripheral input signal. In order to adapt to these adverse stimuli, the central center produces adaptive changes to the bad stimulation activities. This may lead to abnormal synaptic activity in the corresponding neurons, and eventually lead to ultrastructural changes of synapses in certain regions of the cerebral cortex (such as the auditory cortex) and functional recombination, which may perpetuate tinnitus. Tinnitus arises from the cochlea and exists in the center, that is, tinnitus is gradually central. Finally, the clinical diagnosis and treatment of tinnitus based on the central mechanism of tinnitus are discussed.
【作者单位】：上海交通大学医学院附属新华医院耳鼻咽喉头颈外科;上海交通大学医学院耳科学研究所;
【基金】：国家自然科学基金项目(No:81371091,No:81170917,No:30973298) 上海市科委重点基金项目(No:12ZZ103)资助
【分类号】：R764.45

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