突发性聋发病与天气和天体变化的关系

目的 研究分析突发性聋(突聋)发病与季节、月份、月亮盈亏、太阳黑子以及大气温度变化的关系方法 回顾性分析我科2000年-2006年住院治疗的突聋患者发病的具体时间,并对近30年我院突聋住院人数占耳鼻喉科总住院人数的平均构成比与近56年西安市年平均气温进行对比分析.结果 332例突聋中,春季发病66例,夏季发病94例,秋季发病86例,冬季发病87例;9月和8月突聋发病人数最多,5月和10月突聋发病人数最少.农历初一与农历15日突聋发病人数明显多于农历28日和29日的发病人数.农历初一至十五突聋发病185例,农历十六至三十日发病147例,即月亮由新月到满月的突聋发病人数构成比多于月亮由满月到残月的突聋发病人数构成比.近30年太阳黑子爆发高发年是1989年和2000年,太阳黑子爆发低谷年为1996年,这3年我院突聋住院人数占耳鼻喉科总住院人数的构成比分别为1.99%、5.01%和4.23%.与所在年代的我院突聋住院人数占耳鼻喉科总住院人数的平均构成比无显著性差异(P>0.05).研究发现近30年突聋住院病人占我院耳鼻喉科住院人数构成比有逐渐增多趋势,其中上世纪80年代构成比为1.69%、90年代为3.31%、2000年-2009年为4.38%,不同时期突聋住院人数的构成比在统计学上有显著性差异(P<0.01).而近30年西安市的年平均气温明显升高,突聋发病与平均气温升高可能存在一定关系.结论 突聋发病在一年四季中以夏季发病人数最多,9月和8月是突聋发病高发期.月亮圆缺变化可能对突聋发病有一定影响,太阳黑子爆发与突聋发病无明显相关.近30年突聋发病有逐渐增多趋势,可能与CO2排放增加和温室效应导致的大气平均温度升高有关.     

青少年突发性聋的临床特征(附34例报告)

目的：探讨青少年突发性聋（突聋）的临床特点、疗效及影响预后的因素。方法：对３４例（４２耳）１８岁以下青少年突聋患者进行临床观察。结果：①男女患者构成比约为４：１。约１／３患者发病前有较明确的病毒感染史。发病时伴眩晕、耳鸣者分别占４１．２％及７０．６％。初诊时０．２５￣４ＫＨｚ平均听力损失中重度（≥５６ｄＢ）占８４．７％ 间听力曲线全聋型占５４．８％、下降型占２１．４％。②总体疗效为痊愈率４．８％,     

突聋伴或不伴眩晕对听力的影响

调查1972～1990年就诊单侧突聋1313例，初诊及突聋发病后2个月分别测听力。将两次听力、年龄、性别、有无眩晕症状及治疗方法输入计算机综合分析。听力曲线分5型：高频听力损失、低频听力损失、平坦型、重度聋及其它。1313例中392例（29．2％）伴眩晕，915例（69．7％）无眩晕，6例情况不明。年龄6～79岁，平均39．7士14．4岁。眩晕组平均38．0士14．8岁；无眩晕组平均40．4士14．1岁，两组差异显著（P＜o．OI）。听力图分析；重度聋组及高频听力损失组伴眩晕者分别占全组的69．2％及43．3％。年龄小于14岁，重度聋及高频听力损失组占比例…     

伴和不伴眩晕突发性聋患者听性脑干反应波Ⅰ潜伏期初探

目的旨在观察突发性聋（以下简称突聋）是否伴眩晕与听性脑干反应（ABR）的关系。方法对87例伴和不伴眩晕的突聋患者的听性脑干反应资料进行回顾性分析。结果伴有眩晕的突聋患者波Ⅰ潜伏期长于不伴眩晕的患者（P＜0．01）。结论突聋伴眩晕者Ⅰ波潜伏期延长可能为伴膜迷路积水有关。     

中药川芎嗪治疗72例突发性聋的临床分析

突发性聋是耳科的常见多发病之一。在短时间内突然发生和发展为严重的感音神经性聋．病因不明，许多学者认为实聋与血液循环障碍有关。我们应用川芎嗪改善血液循环的功效，治疗实聋取得较好效果。现将1993年2月～1994年2月间治疗的72例分析如下。临床资料一、一般资料72例，男性39例，女性33例。左耳41例，右耳30例，双耳1例，共73耳；发病年龄在7～71岁，30～50岁发病率最高，占51.39％，平均年龄为38岁。就诊时间：最短者4小时，最长者3月余。病程的长短与治疗的效果详见表1。症状：除突发聋外，部分患者还伴有耳鸣及眩晕，伴眩晕者26例（…     

突发性聋与眩晕

突发性聋与眩晕万夷１许时晖突发性聋患者中部分伴有眩晕。对于眩晕与突聋之间的关系一直在不断地探索。多数学者认为突聋伴眩晕者的预后较不伴眩晕者差；少数则提出突聋是否伴有眩晕对预后并无影响。本文回顾性分析了我科自１９９１年～１９９５年１１５例突聋病例，分析...     

突聋预后相关因素的分析

目的：研究影响突聋预后的相关性因素。方法：对146例（167耳）突聋的临床资料进行回顾性分析，并应用SAS system计算机系统进行预后相关因素的研究。结果：年龄小于50岁、发病14d以内就诊治疗以及单耳患病的病人预后较好；伴有眩晕症状、未患病耳既往曾有感音神经性聋病史、初诊时听力损失曲线为全聋型、高频听力（4kHz及8kHz）损失较重以及高频听阈（4kHz 8kHz）大于低频（250Hz 500Hz）听阈的病人预后不佳；治疗方案的选择并不影响病人的预后；多因素分析显示8kHz的听阈水平与预后关系最为密切，其它依次为眩晕、4kHz听阈、就诊时间、损失类型及未患病耳的既往病史。结论：从单、多因素分析的结果可以看出，突聋研究应采用多因素逐步分析的方法进行分析，以使预后和疗效评估更具准确性和客观性。     

肌纤维发育异常致突聋

Kunstmann等报告了一例肌纤维发育异常伴发突聋的病例。患者,女,50岁,右耳初发突聋伴眩晕,入院时纯音听闯测试显示右耳低、中频听力下降（听阈95～100 dB HL）,     

综合治疗突发性耳聋53例疗效分析

我院自１９８６年１月至１９９８年６月共收治突发性耳聋５３例，均采取综合治疗，收到了较好的临床效果，现总结报道如下。１临床资料１．１一般情况：５３例中，男性３７例，女性１６例；年龄最大者７４岁，最小２１岁；左耳２４例，右耳２９例；就诊时间最短为 ２小时，最长为 ３个月，１０天以内就诊者为 ３５例（６６％）；住院时间最短者为２天，最长４０天，平均住院２１天。１．２症状：耳聋均为突然发作，其中中度聋６例，中重度聋１５例，重度聋２１例，极重度及全聋１１例。耳聋前后伴有耳鸣者３１例，有不同程度眩晕１１例，伴…     

突发性聋伴良性阵发性位置性眩晕患者的预后研究

目的：研究突发性聋（突聋）伴良性阵发性位置性眩晕（BPPV）患者的预后情况。方法：分析24例突聋伴BPPV患者的临床资料,并与同期125例突聋不伴BPPV患者进行比较。结果：突聋伴BPPV和突聋不伴BPPV患者治疗后3个月听力恢复的总有效率分别为41．67％和72．80％,差异有统计学意义（P〈O．05）。结论：突聋伴BPPV患者听力的预后比突聋不伴BPPV患者更差,BPPV是突聋患者听力预后不良的一个影响因素。     

A comparative study of mumps deafness and idiopathic profound sudden deafness

Summary We performed a 10-year comparative study on 95 cases (98 ears) of mumps deafness and 97 cases (97 ears) of profound sudden deafness and found the following results. The age of onset of deafness was less than 9 years in the majority of patients with mumps deafness, while it was frequently 30–50 years in those patients with sudden deafness. Among these latter patients, no cases occurred under 9 years of age. The incidence of tinnitus and vestibular symptoms was more frequent in the patients with sudden deafness, but no significant difference was noted in cases over 10 years of age. When determining prognosis, no cases of hearing improvement were encountered in mumps deafness, while about 70% of sudden deafness showed improvement.     

Concurrent symptoms and disease conditions in sudden deafness

Objective To study concomitant symptoms and disease conditions in sudden deafness. Methods Clinical data of 418 cases of sudden deafness treated in this department from 2000 to 2007 were reviewed. Results Of the 418 cases, 201 were males and 217 were females. Right ear was involved in 184 cases and left ear in 191 cases. Bilateral involvement was seen in 43 cases. The average age was 44.1 years. Tinnitus was reported in 369 cases (88.3%) either before or after hearing loss, of which 64.5% was of low pitch, 27.1% of high pitch and 8.4% of mixed tones. Constant tinnitus was reported in 83% of the cases, and muffled feelings in 33.3% of the cases.Hearing loss was the only complaint in 221 cases (52.9%). Dizziness was reported in 77 cases (18.4%) and vertigo attacks in 120 cases (28%). Hypertension, coronary artery disease and diabetes were found in 19.6% of 418 cases and hyperlipidemia in 54.5% of 211 cases. CT and/or MRI data were available in 147 cases, with positive findings in 18 cases (12.3%): 2 with acoustic neuroma (1.36%); 4 with emphraxis in the basal ganglia, cerebellum, temporal lobe or parietal lobe, and 12 with poor pneumatization of ipsior contralateral mastoid cells. Conclusion In this case series of sudden deafness, low-pitch constant tinnitus was a common complaint. Most of the studied cases presented with simple hearing loss. Vertigo attacks were more common than dizziness in this group of patients. The most common concomitant disorder was hyperlipidemia, especially high triglycerides. Imaging studies are important in managing sudden deafness in ruling out acoustic neuroma and other intracranial diseases.     

A comparative study of mumps deafness and idiopathic profound sudden deafness

We performed a 10-year comparative study on 95 cases (98 ears) of mumps deafness and 97 cases (97 ears) of profound sudden deafness and found the following results. The age of onset of deafness was less than 9 years in the majority of patients with mumps deafness, while it was frequently 30-50 years in those patients with sudden deafness. Among these latter patients, no cases occurred under 9 years of age. The incidence of tinnitus and vestibular symptoms was more frequent in the patients with sudden deafness, but no significant difference was noted in cases over 10 years of age. When determining prognosis, no cases of hearing improvement were encountered in mumps deafness, while about 70% of sudden deafness showed improvement.     

突发性聋预后的相关因素分析及疗程选择

目的 探讨突发性聋预后的相关因素及疗程选择。 方法 回顾性分析突发性聋患者185例(228耳)的临床资料,分别就性别、年龄、耳侧、伴随症状、听力曲线类型、发病至治疗时间、损伤频率平均听阈及疗程对总有效率的影响,筛选出相关因素后行多因素二元Logistic回归分析。 结果 228耳中无效144耳,有效31耳,显效23耳,痊愈30耳,总有效率为36.8%。单因素分析显示,性别、年龄、听力曲线类型、发病至治疗时间、损伤频率平均听阈及疗程均与总有效率密切相关(P<0.05),而与耳侧及眩晕、耳鸣及耳闷等伴随症状无关(P>0.05)。多因素回归分析表明,性别、年龄、听力曲线类型、发病至治疗时间、疗程与总有效率有相关性(P<0.05),而听力损伤频率平均听阈与总有效率无关(P>0.05)。 结论 女性患者预后优于男性患者;随着年龄增大、发病至治疗时间的延长,总有效率呈下降趋势;低频下降型预后最好,平坦下降型、全聋型次之,高频下降型最差。早期治疗可提高临床疗效,而对第1疗程无效者,宜再继续治疗2个疗程。     

突发性聋的疗效与听力曲线图的关系

目的：探讨突发性聋疗效与听力曲线图之间的关系。方法对328例（340耳）突发性聋病例进行回顾性分析,探讨其治疗前听力曲线图与预后的相关性。结果所有病例治疗前听力曲线图可以分为上升、山型、下降、凹陷、平坦和全聋型,统计各型与疗效的相关性。340耳总有效率为65%,各听力曲线图型疗效从高到低分别为上升型（92.1%）、山型（84.4%）、下降型（45.3%）、凹陷型（72.5%）、平坦型（80.6%）、全聋型（31.0%）,疗效组间差异有统计学意义（χ2=104.67, P＜0.001）。结论突发性聋患者治疗前听力曲线图与疗效相关,以上升型和山型疗效最好,下降型、全聋型最差。     

高压氧综合治疗突发性耳聋预后相关因素分析

目的：根据临床资料建立预测高压氧（hyperbaric oxygen,HBO）综合治疗突发性耳聋（sudden deafness,SD）预后的评分模型,并评价科学性。方法连续选择188例（221耳）接受高压氧综合治疗的SD患者,随机分为两组：训练样本168例（201耳）,验证样本20例（20耳）。采用自身前后对照试验方案,根据训练样本实际疗效分为有效和无效两组,应用X2检验筛选出有统计学意义的危险因素并赋值,建立评分模型,并进行受试者工作特征曲线（receiver operator characteristic curve,ROC）分析。结果 SD伴眩晕、听力曲线呈下降/全聋型、发病至就诊时间≥15 d、HBO治疗疗程＜2个疗程、HBO开始治疗时间≥15 d、就诊平均听力损失≥60 dB HL、SD合并高血压（high blood pressure,HBP）或糖尿病（diabetes mellitus,DM）或二者兼有是影响高压氧综合治疗突发性耳聋预后的危险因素。应用ROC分析该评分模型,曲线下面积（area under the curve,AUC）为0.967,与完全随机情况下获得的曲线下面积（0.5）相比有显著差异,P〈0.05。经验证样本前瞻性误判概率评估,误判率约10％。结论根据临床资料建立预测HBO综合治疗SD预后的评分模型可以预估SD预后,对临床治疗有一定指导意义。     

突发性聋的早期治疗及超氧化物歧化酶和丙二醛检测

OBJECTIVE: To explore the effect of treatment on sudden deafness at ultra-early stage and the influence on Malonyldialdehyde (MDA) and superoxide dismutase(SOD) of serum. METHODS: One hundred and forty-seven cases of sudden deafness (168 ears) from July 1995 to June 2001 were divided into three groups, 29 cases (36 ears) in group I treated within 6 hours after deafness, 55 cases(63 ears) in group II treated within 15 days after deafness, and 63 cases (69 ears) in group III treatment after 15 days after deafness. Total cases were treated with medicine and hyperbaric oxygen and the volume of SOD and MDA of serum were observed at the same time. There were 30 healthy volunteers as control group. RESULTS: In the group I, the hearing threshold was recovered in 18 ears, significant improved in 9 ears, improved in 7 ears and not changed in 2 ears after treatment. In the group II, the hearing threshold was recovered in 11 ears, significant improved in 16 ears, improved in 15 ears and no changed in 21 ears after treatment. In the group III, the hearing threshold was recovered in 14 ears, significant improved in 20 ears, improved in 13 ears and no changed in 22 ears after treatment. There was a significant difference in improved level of hearing between the group I and group II. (chi 2 = 9.90, P < 0.01) and between group I and group III (chi 2 = 9.30, P < 0.01). There was no significant difference between group II and group III (chi 2 = 0.03, P > 0.01). CONCLUSION: The treatment on sudden deafness in ultra-early stage is very important. The use of free radical scavenger early can protect audio nerve.     

突发性聋耳声发射与预后的关系

目的本文旨在了解突发性聋患者耳声发射的变化与预后的关系. 方法利用GSI-60型及CELESTA-503 型耳声发射检测仪对29例突发性聋的患者进行了畸变产物耳声发射(DPOAE)的测试,并对其进行了治疗和随访. 结果患耳的DPOAE检出率、幅值低于健耳与正常组,检测阈升高.OAE 检出率与预后的相关性检验无显著相关性. 结论突聋患者OAE 呈中重度感音神经性听力下降的改变.OAE检出与否与预后好坏无统计学意义上的相关性.     

1158例突发性聋患者听力情况分析

目的分析大样本突聋患者听力损失情况。方法对1158例患者（1203耳）进行病史询问及听力学检查,按听力损失频率及损失频率平均听阈分类,部分患者行颞骨CT及头颅MRI检查。结果1158例患者中14．3％为低、中频听力下降,6．2％为中、高频听力下降,15．1％为高频听力下降,4．4％为低、高频听力下降,60．0％为全频听力下降。1158例中查出1例听神经瘤,2例大前庭水管综合征。结论突聋患者听力损失情况不一,以全频下降为主,应注意排除相关疾病。     

儿童突发性聋的临床特征及预后相关因素分析

目的 分析儿童突发性聋的临床特征、疗效及影响预后的相关因素,为临床治疗及预后评估提供依据。 方法 收集2010年1月至2017年10月就诊的67例突发性聋患儿临床资料,对其临床特征及治疗效果进行回顾性分析,同时根据疗效将患者分为总体有效组(36例)及无效组(31例),采用单因素及多因素分析的方法分析患者的性别、年龄、病程、初诊听阈、是否伴发耳鸣、眩晕、病毒感染史、发病季节和听力曲线类型对预后的影响。 结果 儿童突聋患者中64.18%在春冬季发病,其就诊时听阈为(76.62±25.97)dB HL,耳鸣及眩晕伴发率分别为70.15%和61.19%,病毒感染率为19.40%,听力曲线中10.44%为低频下降型、2.99%为高频下降型、34.33%为平坦型及52.24%为全聋型。经治疗后,患者听阈为(60.41±31.52)dB HL,总体有效率为53.73%,其中痊愈率、显效率及有效率分别为20.90%、16.42%和16.42%。多因素分析结果显示,初诊听阈越高及听力曲线为全聋型,预后越差(P均<0.05);伴有病毒感染的非全聋型患者预后较好(P<0.05)。 结论 儿童突发性聋患者病毒感染率较高且大部分在春冬季发病,就诊时听力损失较重并常伴有耳鸣及眩晕,其听力曲线以平坦型及全聋型为主。就诊时听力损伤程度轻、伴有病毒感染的非全聋型患者预后较好。