以突发性听力损失为首发症状病例的病因探讨

目的　探讨以突发性听力损失为首发症状病例的可能病因。方法　对 16 0例患者作回顾性分析。结果　近期有病毒感染史者达 36 .9% ;其中上感占 31.3 % ,居首位 ;第二位为血管性因素 ,占 2 6 .9% ;8例与自身免疫性疾病有关 ;2 0例与内淋巴积水 (EH)有关 ,其中 2例诊断为梅尼埃病 ;有噪声暴露史者达 2 5 .6 %。结论　近期有上感史 ,咽部充血即可考虑为病毒性因素 ;血沉升高可作为自身免疫性疾病的非特异性筛选指标 ;与脑血管功能障碍有关的项目应详查 ;详细的过去病史及随访对不同类型EH的诊断至关重要 ;既往各种听损伤耳病史在突聋发病中的意义有待探讨

Clinical Etiological Analysis for Sudden Deafness as First Symptom

Objective To probe the etiology of sudden deafness (SD) manifested as first symptrom.Methods A retrospective analysis was performed in 160 cases of SD.Results History of viral infection reached 36.9% in 160 cases before deafness,in which the upper respiratory tract infection was 31.3%.The percentage of dysfunction of brain circulation was 26.9%.Autoimmune disease was found in 8 cases and endolymphatic hydrops(EH)in 20 cases,among which Meniere's disease was diagnosed in 2 cases.The history of noise exposure was 25.6% in 160 cases.Conclusion Viral infection was the first place of the pathogenic factors of SD and history of the upper respiratory tract infection before deafness and congestion of the throat should be considered as viral factor.The disturbance of brain circulation was the second place and the relating items should be examined.The factor of autoimmune was not unusual and the erythrocyte sedimentation elevated might be a nonspecific screen index for the disease.The different types of EH might express as SD,a detailed past history and follow-up were of utmost importance for the diagnosis of EH.The significance of ear damage factors in past history should be approached in the future.