摘要
目的分析纯音测听各频率听阈均未引出的全聋型突发性耳聋的临床特征和预后情况,为制定治疗方案提供参考。方法回顾性研究郑州大学第二附属医院2016年1月~2019年3月就诊的143例全聋型突发性耳聋患者,纯音测听结果各频率均未引出,均为单侧发病,年龄为22岁~74岁,采用突聋指南(2015)推荐治疗方案:银杏叶提取物+前列地尔+甲钴胺+口服激素+巴曲酶治疗。分析发病时首发症状及治疗过程中听力下降、耳鸣、眩晕(头晕)、耳闷改善的先后顺序。探讨各频率的预后情况。结果耳鸣为最常见的首发症状共60人(46.36%),其次为听力下降共43人(39.16%),听力下降与眩晕同时首发为18人(12.59%);治疗过程中,眩晕最先得到改善(≤7天),但头昏沉可以长期存在,听力改善的起始时间≤10天为23例、10-20天46例、20-30天11例、≥30天17例,而耳鸣、耳闷持续时间较长,不易改善,耳鸣可转为慢性。125Hz-8kHz听力总有效率分别为65.73%、63.64%、64.33%、61.54%、55.94%、54.55%、50.35%。3例痊愈的识别率为80%、84%、88%。言语识别率平均值为28%。结论各频率均未引出的全聋型突发性耳聋多合并眩晕,治愈率低且中低频较高频易改善但言语识别率差;该类型突聋患者症状改善慢,可酌情延长治疗时间。
Objective To report clinical characteristics and prognosis of total sudden hearing loss with no pure tone response at all frequencies.Methods One hundred and forty three patients(aging from 22 to 74 years)with unilateral SSHL diagnosed and treated at the Second Affiliated Hospital of Zhengzhou University from January,2016 to March,2019,showing no pure tone response at all frequencies were included in the study.The patients were treated with a standard treatment regimen with ginkgo biloba extract+prostol+mecobalamin+oral steroids+batrotase.Clinical features and treatment outcomes were analyzed.Results Tinnitus was the most common initial symptom in 60 patients(46.36%),followed by hearing loss in 43 patients(39.16%),and hearing loss plus vertigo in 18 patients(12.59%).In the course of treatment,vertigo was the first symptom to improve(7 days),although lightheadedness might persist,followed by hearing,while tinnitus and ear fullness lasted for a long time.In some patients,tinnitus became a chronic symptom.Conclusion Vertigo is the most common symptom in patients with total sudden hearing loss.Outcomes are often poor.Improvement in patients with this type of sudden deafness may take time and require extended periods of treatment.
作者
张慧
闫瑞红
李仲
王蕾
单子丽
代佳
李亚玲
耿曼英
ZHANG Hui;YAN Ruihong;LI Zhong;WANG Lei;SHAN Zili;DAI Jia;LI Yaling;Geng Manying(Department of Oyorhinolarygology-Head and Neck Surgery,Second Affiliated Hospital,Zhengzhou University,Zhengzhou,Henan 450014,China;The Third People’s Hospital of Henan Province,Zhengzhou,450000,China)
出处
《中华耳科学杂志》
CSCD
北大核心
2020年第6期1029-1033,共5页
Chinese Journal of Otology
基金
河南省科技攻关计划普通项目(20130384,201702093)。
关键词
突发性耳聋
全聋型
临床特征
预后
Sudden Hearing Loss
Total deafness
Clinical Characteristics
Prognosis
