突然发生的双耳感音神经性听力损失病因及临床表现特征分析

发布时间：2019-01-01 12:43

【摘要】：【目的】分析突发双耳感音神经性听力损失的病因及临床表现特征,为进一步提高诊疗质量提供数据支持。【方法】因突发双耳感音神经性听力损失入院,最终病因明确的病例19例,分析其临床表现特征。【结果】按照发病率高低依次为:1双侧内耳畸形10例。其中前庭扩大5例,前庭导水管扩大3例,前庭及前庭导水管均扩大1例,前庭扩大伴耳蜗发育不全1例。单纯前庭扩大畸形,初次发作感音神经性听力损失时程度为中度,经治疗并积极控制诱因,2例恢复正常,随访3年无复发;3例听力较发病时好转,纯音听阈在中度以内波动。其他类型畸形5例听力逐渐下降至重度以上。2癔症性听力损失8例,其中学龄儿童及青少年共6例,均可查及特殊的生活背景;中年女性2例,发病前有特殊的情感经历。8例患者经积极治疗后听力恢复。3肺癌颅内及左侧内听道转移1例,左耳全聋、右耳轻度听力损失,虽经及时治疗,双耳听力均无改善。【结论】儿童突发双侧感音神经性听力损失患者易误诊,双侧前庭、前庭导水管扩大或合并其他畸形听力预后较差,有必要于首诊时完善影像学检查。癔症性听力损失发病率近年有升高趋势,仍以儿童患者为主(6/8)应对其诱因进行关注并给予及时有效的处理。肺癌内听道转移则极为罕见,对中老年双侧感音神经性听力损失患者建议必要的影像学检查。
[Abstract]:[objective] to analyze the etiology and clinical manifestation of sudden hearing loss of auricular sensorineural hearing in order to provide data support for further improving the quality of diagnosis and treatment. [methods] the patients were admitted to hospital because of sudden hearing loss caused by auricular sensorineural hearing loss. The clinical manifestations of 19 cases with definite etiology were analyzed. [results] according to the incidence rate, 10 cases had bilateral inner ear malformation. Vestibular dilatation in 5 cases, vestibular aqueduct enlargement in 3 cases, vestibular and vestibular aqueduct dilatation in 1 case, vestibular dilatation with cochlear dysplasia in 1 case. The degree of hearing loss was moderate at the time of the first attack of sensorineural hearing loss. After treatment and positive control of the inducement, 2 cases returned to normal, and no recurrence occurred after 3 years follow-up. The hearing of 3 cases was better than that of the onset, and the pure tone hearing threshold fluctuated within the moderate range. Other types of deformities were gradually reduced to severe hearing loss in 5 cases. 2 hysterical hearing loss was found in 8 cases, including 6 cases of school-age children and adolescents. Two middle-aged women had special emotional experience before onset. 8 patients recovered hearing after active treatment. 3 there were 1 case of intracranial and left auditory metastasis, 1 case of total deafness in left ear, slight hearing loss in right ear, although treated in time. [conclusion] Children with sudden bilateral sensorineural hearing loss are prone to misdiagnosis, bilateral vestibule, vestibular aqueduct enlargement or associated with other malformation of hearing prognosis is poor, it is necessary to improve the imaging examination at the first visit. The incidence of hysterical hearing loss has been increasing in recent years, and it is still mainly children (6 / 8) who should pay attention to its inducement and deal with it in a timely and effective manner. The metastasis of internal auditory canal in lung cancer is extremely rare. The necessary imaging examination is recommended for the aged patients with bilateral sensorineural hearing loss.
【作者单位】：中山大学附属第三医院耳鼻咽喉-头颈外科;
【基金】：广东省科技计划项目(2012B061700073)
【分类号】：R764.437

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