突发性聋伴或不伴眩晕的临床分析

周枫; 朱美婵; 王蒙; 王海涛; 焦粤龙; 黄利芬; 梁子健

doi:10.13201/j.issn.1001-1781.2018.12.009

突发性聋伴或不伴眩晕的临床分析

- 广州市耳鼻咽喉头颈外科医院(广州市第十二人民医院)耳鼻咽喉头颈外科广州医科大学耳鼻咽喉头颈外科研究所(广州, 510620)

详细信息

通讯作者: 周枫,E-mail:zhoufengguangzhou@163.com

中图分类号: R764.3

收稿日期: 2018-01-22

Clinical analysis of idiopathic sudden sensorineural hearing loss with vertigo and without vertigo

- Department of Otorhinolaryngology, Otorhinolaryngology Head and Neck Surgery Hospital of Guangzhou(Guangzhou No. 12 Hospital), Otorhinolaryngology Head and Neck Surgery Institute of Guangzhou Medical University, Guangzhou, 510620, China

More Information

Corresponding author: ZHOU Feng, E-mail: zhoufengguangzhou@163.com

Received Date: 22 January 2018

摘要

摘要: 目的：探讨伴及不伴眩晕的突发性聋患者的临床特点及治疗方法。方法：突发性聋患者120例，其中不伴眩晕84例，伴眩晕36例。伴眩晕的36例患者中15例伴良性阵发性位置性眩晕（BPPV）。全部患者均进行突发性聋的常规治疗，伴BPPV患者按照BPPV类型进行相应的手法复位治疗。对突发性聋患者的纯音测听结果及疗效等进行统计学分析，总结突发性聋伴及不伴眩晕患者的临床特点。结果：突发性聋伴眩晕患者的纯音听力结果中，低中频下降型、中高频下降型及全聋型的发生率无统计学差异，但平坦下降型发生率较其他3型高。突发性聋不伴眩晕患者治疗后的听阈降低值高于突发性聋伴眩晕者，且治疗后听力的显效率、有效率及总有效率也高于突发性聋伴眩晕者。突发性聋伴眩晕的BPPV患者中，后半规管12例，外半规管3例，均为同侧患耳。结论：突发性聋伴眩晕患者较非眩晕突发性聋患者听力损失严重，且治疗后听力改善及疗效较差。
- 眩晕 /
- 听觉丧失,突发性 /
- Epley法复位 /
- Barbecue法复位
Abstract: Objective: To explore the clinical characteristics and treatments of patients with idiopathic sudden sensorineural hearing loss(ISSHL) with or without vertigo.Method: One hundred and twenty ISSHL cases were divided into vertigo group (n=36), without vertigo group (n=84), and with benign paroxysmal positional vertigo group (n=15). All patients were in regular treatment. Besides, according to the types of BPPV, patients do the Epley maneuver or Barbecue roll maneuver. We summarized the result and treatment of the patients.Result: The audiometric curve of ISSHL with vertigo were mainly at flat type. After treatment of the ISSHL patients were better than the patients with vertigo in the degrees of hearing loss. Furthermore, the rate of the patients of marked efficiency, efficiency and total efficiency of ISSHL was lower than the ones without.The patients with BPPV, including 12 cases of posterior semicircular canal and the 3 cases of lateral semicircular canal, were all ipsilateral.Conclusion: ISSHL with vertigo group lost hearing is severer than ISSHL without vertigo. Thus the hearing and the treatment effect were worse.The symptoms without vertigo in ISSHL were better than the patients with vertigo.
- vertigo /
- hearing loss,sudden /
- Epley maneuver /
- Barbecue roll maneuver

HTML全文

参考文献(17)

[1]	KIM C H, CHOI J M, JUNG H V, et al.Sudden sensorineural hearing loss with simultaneous positional vertigo showing persistent geotropic direction-changing positional nystagmus[J].Otol Neurotol, 2014, 35:1626-1632.
[2]	ATAY G, KAYAHAN B, ÇINAR BÇ, et al.Prognostic Factors in Sudden Sensorineural Hearing Loss[J].Balkan Med J, 2016, 33:87-93.
[3]	RAUCH S D.Clinical practice.Idiopathic sudden sensorineural hearing loss[J].N Engl J Med, 2008, 359:833-840.
[4]	中国突发性聋多中心临床研究协作组.中国突发性聋分型治疗的多中心临床研究[J].中华耳鼻咽喉头颈外科杂志, 2013, 48(5):355-361.
[5]	GOEBEL J A, O'MARA W, GIANOLI G.Anatomic considerations in vestibular neuritis[J].Otol Neurotol, 2001, 22:512-518.
[6]	KITAHARA T, TAKEDA N, NISHIIKE S, et al.Prognosis of inner ear periphery and central vestibular plasticity in sudden deafness with vertigo[J].Ann Otol Rhinol Laryngol, 2005, 114:786-791.
[7]	MATSUSHIRO N, DOI K, FUSE Y, et al.Successful cochlear implantation in prelingual profound deafness resulting from the common 233delC mutation of the GJB2 gene in the Japanese[J].Laryngoscope, 2002, 112:255-261.
[8]	CHANG N C, HO K Y, KUO W R.Audiometric patterns and prognosis in sudden sensorineural hearing loss in southern Taiwan[J].Otolaryngol Head Neck Surg, 2005, 133:916-922.
[9]	KORRES S, BALATSOURAS D G, FEREKIDIS E.Prognosis of patients with benign paroxysmal positional vertigo treated with repositioning manoeuvres[J].J Laryngol Otol, 2006, 120:528-533.
[10]	BABIC B B, JESIC S D, MILOVANOVIC J D, et al.Unintentional conversion of benign paroxysmal positional vertigo caused by repositioning procedures for canalithiasis:transitional BPPV[J].Eur Arch Otorhinolaryngol, 2014, 271:967-973.
[11]	屈永涛, 张慧平, 陈红耀, 等.糖皮质激素联合脱水剂治疗低中频突发性聋82例临床体会[J].临床耳鼻咽喉头颈外科杂志, 2016, 30(16):1322-1324, 1328.
[12]	STACHLER R J, CHANDRASEKHAR S S, ARCHER S M, et al.Clinical practice guideline:sudden hearing loss[J].Otolaryngol Head Neck Surg, 2012, 146(3Suppl):S1-35.
[13]	巩楠, 张晓彤, 葛丽荞, 等.突发性聋伴眩晕的临床特点分析[J].临床耳鼻咽喉头颈外科杂志, 2015, 29(22):1963-1965, 1969.
[14]	钟俊伟, 区永康, 黄秋红, 等.突发性聋伴良性阵发性位置性眩晕患者的特点[J].临床耳鼻咽喉头颈外科杂志, 2016, 30(14):1118-1120.
[15]	YU H, LI H.Vestibular Dysfunctions in Sudden Sensorineural Hearing Loss:A Systematic Review and Meta-analysis[J].Front Neurol, 2018, 9:45-45.
[16]	王秋菊, 冰丹.突发性聋的分型诊治与临床研究新进展[J].临床耳鼻咽喉头颈外科杂志, 2016, 30(14):1095-1099.
[17]	周霓, 李玲波.突发性聋预后相关因素的研究进展[J].临床耳鼻咽喉头颈外科杂志, 2017, 31(4):323-326.