The research of the contralateral ear hearing thresholds and the hearing prognosis in unilateral Meniere's disease
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摘要: 目的 通过分析单侧梅尼埃病患耳和对侧耳的纯音测听结果，探讨对侧耳的听阈与单侧梅尼埃病患耳听阈转归的关系。方法 纳入在北京同仁医院确诊并连续入组的单侧梅尼埃病135例患者，在规范治疗下完成1年的随访，分析患耳和对侧耳在首次就诊时和1年后的纯音听阈结果。结果 ① 入组时，对侧耳听力正常组和高频听力下降组的患耳平均听阈差异无统计学意义(P>0.05)。②对侧耳听力正常组的患耳听阈改善范围较对侧耳高频听力下降组更大。在对侧耳听力正常组中，患耳0.25 kHz(P＜0.01)、0.50 kHz(P＜0.01)、1.00 kHz(P＜0.01)、2.00 kHz(P＜0.05)听阈显著改善；在对侧耳高频听力下降组中，仅有0.25 kHz(P＜0.01)听阈获得改善，其他常规测听频率在治疗前后差异均无统计学意义(P>0.05)。此现象在高年龄组和低年龄组中结果一致。③全部患者经过规范治疗并完成1年随访后，患耳的低中频听阈获得改善。0.25 kHz(P＜0.01)、0.50 kHz(P＜0.01)、1.00 kHz(P＜0.01)听阈显著改善；8.00 kHz听阈略有下降(P＜0.05)。结论 梅尼埃病患者经过规范治疗后，低中频听力可获良好的改善效果，但高频听力略有下降，且对侧耳听阈正常的患耳较高频听阈异常者的听阈改善更为明显。Abstract: Objective This study analyzed the pure tone audiometry results of the affected ear and the contralateral ear of unilateral Meniere's disease to investigate the correlation of the hearing threshold of the contralateral ear and the hearing prognosis of unilateral Meniere's disease.Methods In this study, the follow-up data of 135 patients with unilateral Meniere's disease in Beijing Tongren Hospital were used to analyze the pure tone audiometry results of the affected and contralateral ears at the first visit and 1 year later.Results ① At the first visit, there was no statistically significant difference between the mean hearing thresholds of the affected ear in the normal hearing group and the high-frequency hearing loss group of the contralateral ear(P>0.05). ②The range of improvement of hearing thresholds in the affected ear was greater in the contralateral ear normal hearing group than in the contralateral ear high-frequency hearing loss group. In the normal hearing group of the contralateral ear, the hearing thresholds of the affected ear at 0.25 kHz(P < 0.01), 0.50 kHz(P < 0.01), 1.00 kHz(P < 0.01), and 2.00 kHz(P < 0.05) were significantly improved; and in the high-frequency hearing loss group of the contralateral ear, the hearing thresholds at 0.25 kHz(P < 0.01) hearing thresholds improved significantly, and there was no significant difference between the rest of the frequencies before and after treatment(P>0.05). A consistent pattern was observed in both higher and lower age groups. ③After 1 year of follow-up, the low and mid-frequency hearing of the affected ear improved. 0.25 kHz(P < 0.01), 0.50 kHz(P < 0.01), 1.00 kHz(P < 0.01) hearing thresholds improved significantly; 8.00 kHz hearing thresholds decreased slightly(P < 0.05).Conclusion After standardized treatment, the results of 1-year follow-up suggested that the low-frequency hearing of MD patients could be improved, but the high-frequency hearing was slightly decreased. The hearing prognosis of the affected ear with normal hearing threshold of the contralateral ear may be better.
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Key words:
- Meniere's disease /
- hearing thresholds /
- high frequency
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表 1 不同测试频率双耳的平均听阈及双耳听阈差值
dB，M(Q1，Q3) 类别 频率/kHz 0.50、1.00、2.00、4.00 kHz
平均听阈0.25 0.50 1.00 2.00 4.00 8.00 患耳 50(40，60) 50(40，60) 40(25，55) 30(15，45) 35(15，50) 45(25，60) 38.75(26.25，51.25) 对侧耳 10(10，15) 10(10，15) 10(10，15) 10(5，15) 10(5，25) 15(5，35) 11.25(8.75，17.5) 双耳听阈差 35(25，50) 35(25，50) 25(15，45) 15(5，35) 15(5，30) 20(5，35) 22.5(13.75，38.75) 
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表 2 治疗前后患耳各频率纯音听阈
dB，M(Q1，Q3) 时间点 频率/kHz 0.50、1.00、2.00、4.00 kHz
平均听阈0.25 0.50 1.00 2.00 4.00 8.00 治疗前 50(40，60) 50(40，60) 40(25，55) 30(15，45) 35(15，50) 45(25，60) 38.75(26.25，51.25) 治疗1年后 35(20，50) 40(20，50) 30(15，55) 30(10，40) 35(15，55) 50(30，65) 31.25(17.5，46.25) P ＜0.01 ＜0.01 ＜0.01 0.071 0.894 0.018 ＜0.01
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[1] Oberman BS, Patel VA, Cureoglu S, et al. The aetiopathologies of Ménière's disease: a contemporary review[J]. Acta Otorhinolaryngol Ital, 2017, 37(4): 250-263. doi: 10.14639/0392-100X-793
[2] 中华耳鼻咽喉头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉头颈外科学分会. 梅尼埃病诊断和治疗指南(2017)[J]. 中华耳鼻咽喉头颈外科杂志, 2017, 52(3): 167-172. https://cpfd.cnki.com.cn/Article/CPFDTOTAL-ZGZP201709006018.htm
[3] Zhang Y, Liu B, Wang R, et al. Characteristics of the Cochlear Symptoms and Functions in Meniere's Disease[J]. Chin Med J(Engl), 2016, 129(20): 2445-2450.
[4] 朱倩晨, 张康佳, 邹曙光, 等. 波动性感音神经性听力损失的研究进展[J]. 临床耳鼻咽喉头颈外科杂志, 2023, 37(3): 238-242. https://lceh.whuhzzs.com/article/doi/10.13201/j.issn.2096-7993.2023.03.017
[5] Sajjadi H, Paparella MM. Meniere's disease[J]. Lancet, 2008, 372(9636): 406-414. doi: 10.1016/S0140-6736(08)61161-7
[6] Moon IJ, Park GY, Choi J, et al. Predictive value of electrocochleography for determining hearing outcomes in Ménière's disease[J]. Otol Neurotol, 2012, 33(2): 204-210. doi: 10.1097/MAO.0b013e318241b88c
[7] Kim MB, Choi J, Park GY, et al. Clinical Value of Vestibular Evoked Myogenic Potential in Assessing the Stage and Predicting the Hearing Results in Ménière's Disease[J]. Clin Exp Otorhinolaryngol, 2013, 6(2): 57-62. doi: 10.3342/ceo.2013.6.2.57
[8] 罗淳. 关于人口年龄组的重新划分及其蕴意[J]. 人口研究, 2017, 41(5): 16-25. https://www.cnki.com.cn/Article/CJFDTOTAL-RKYZ201705002.htm
[9] Tyrrell JS, Whinney DJ, Ukoumunne OC, et al. Prevalence, associated factors, and comorbid conditions for Ménière's disease[J]. Ear Hear, 2014, 35(4): e162-169. doi: 10.1097/AUD.0000000000000041
[10] Huppert D, Strupp M, Brandt T. Long-term course of Menière's disease revisited[J]. Acta Otolaryngol, 2010, 130(6): 644-651. doi: 10.3109/00016480903382808
[11] Stahle J, Friberg U, Svedberg A. Long-term progression of Meniére's disease[J]. Acta Otolaryngol Suppl, 1991, 485: 78-83.
[12] Albera R, Canale A, Cassandro C, et al. Relationship between hearing threshold at the affected and unaffected ear in unilateral Meniere's disease[J]. Eur Arch Otorhinolaryngol, 2016, 273(1): 51-56. doi: 10.1007/s00405-014-3466-8
[13] Zhang Y, Wei C, Sun Z, et al. Hearing Benefits of Clinical Management for Meniere's Disease[J]. J Clin Med, 2022, 11(11): 3131. doi: 10.3390/jcm11113131
[14] Hoa M, Friedman RA, Fisher LM, et al. Prognostic implications of and audiometric evidence for hearing fluctuation in Meniere's disease[J]. Laryngoscope, 2015, 125 (Suppl 12): S1-12.
[15] 于生元, 万琪, 王武庆, 等. 前庭性偏头痛诊治专家共识(2018)[J]. 中国疼痛医学杂志, 2018, 24(7): 481-488. https://www.cnki.com.cn/Article/CJFDTOTAL-ZTYZ201807002.htm
[16] Shi S, Wang D, Ren T, et al. Auditory Manifestations of Vestibular Migraine[J]. Front Neurol, 2022, 13: 944001. doi: 10.3389/fneur.2022.944001
[17] Lempert T, von Brevern M. Vestibular Migraine[J]. Neurol Clin, 2019, 37(4): 695-706. doi: 10.1016/j.ncl.2019.06.003
[18] 韩援朝, 李泽卿, 王瑞, 等. 梅尼埃病的高频测听观察[J]. 听力学及言语疾病杂志, 1998, 6(4): 172-173. https://www.cnki.com.cn/Article/CJFDTOTAL-TLXJ199804001.htm
[19] Savastano M, Guerrieri V, Marioni G. Evolution of audiometric pattern in Meniere's disease: long-term survey of 380 cases evaluated according to the 1995 guidelines of the American Academy of Otolaryngology-Head and Neck Surgery[J]. J Otolaryngol, 2006, 35(1): 26-29. doi: 10.2310/7070.2005.4092
[20] Hildesheimer M, Rubinstein M, Nuttal AL, et al. Influence of blood viscosity on cochlear action potentials and oxygenation[J]. Hear Res, 1982, 8(2): 187-198. doi: 10.1016/0378-5955(82)90074-0
[21] Park DJ, Ha S, Choi JS, et al. Induced Short-Term Hearing Loss due to Stimulation of Age-Related Factors by Intermittent Hypoxia, High-Fat Diet, and Galactose Injection[J]. Int J Mol Sci, 2020, 21(19): 7068. doi: 10.3390/ijms21197068
[22] Seo YJ, Chung HJ, Park SY, et al. Lowest Oxyhemoglobin Saturation May Be an Independent Factor Influencing Auditory Function in Severe Obstructive Sleep Apnea[J]. J Clin Sleep Med, 2016, 12(5): 653-668. doi: 10.5664/jcsm.5786
[23] Liu Y, Jia H, Shi J, et al. Endolymphatic hydrops detected by 3-dimensional fluid-attenuated inversion recovery MRI following intratympanic injection of gadolinium in the asymptomatic contralateral ears of patients with unilateral Ménière's disease[J]. Med Sci Monit, 2015, 21: 701-707. doi: 10.12659/MSM.892383
[24] Guajardo-Vergara C, Suárez-Vega V, Dominguez P, et al. Endolymphatic hydrops in the unaffected ear of patients with unilateral Ménière's disease[J]. Eur Arch Otorhinolaryngol, 2022, 279(12): 5591-5600. doi: 10.1007/s00405-022-07412-9
[25] Shojaku H, Watanabe Y, Yagi T, et al. Changes in the characteristics of definite Meniere's disease over time in Japan: a long-term survey by the Peripheral Vestibular Disorder Research Committee of Japan, formerly the Meniere's Disease Research Committee of Japan[J]. Acta Otolaryngol, 2009, 129(2): 155-160. doi: 10.1080/00016480802112587
[26] House JW, Doherty JK, Fisher LM, et al. Meniere's disease: prevalence of contralateral ear involvement[J]. Otol Neurotol, 2006, 27(3): 355-361. doi: 10.1097/00129492-200604000-00011
[27] Moleon M, Torres-Garcia L, Batuecas-Caletrio A, et al. A Predictive Model of Bilateral Sensorineural Hearing Loss in Meniere Disease Using Clinical Data[J]. Ear Hear, 2022, 43(3): 1079-1085. doi: 10.1097/AUD.0000000000001169
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