影响特发性突聋疗效的因素分析

目的 :了解影响特发性突聋临床疗效的有关因素。方法 :对 5 0例 (5 2耳 )不同性别、年龄、病程、听力损害程度及眩晕的有无 5个方面特发性突聋者的临床资料进行综合回顾性分析。结果 :性别的差异 ,年龄的大小 ,病程的长短对疗效差异的影响并不显著 ,但是听力损失的程度和眩晕 (两者均是P <0 0 0 5 ) ,有统计学意义。结论 :听力损失的程度和眩晕是影响特发性突聋疗效的肯定因素     

突发性耳聋患者HMGB1和VE-cadherin含量变化的意义

目的探讨突发性耳聋患者血清高迁移率蛋白-1（HMGB1）和血管内皮细胞钙黏蛋白（VE-cadherin）的含量变化,及其在突发性耳聋发生过程中的作用和意义。方法采用酶联免疫（ELISA）法检测血清HMGB1和VE-cadherin含量;检测102例突发性耳聋患者、35例其他疾病对照组和30例正常健康对照组的血清HMGB1和VE-cadherin含量,并比较治疗前后血清HMGB1和VE-cadherin的测定结果。结果突发性耳聋患者治疗前血清HMGB1和VE-cadherin含量较两对照组显著升高（P〈0.01）;治疗后恢复组患者HMGB1和VE-cadherin含量明显降低。突发性耳聋患者血清HMGB1和VE-cadherin含量之间呈正相关（r=0.68,P〈0.01）。结论血清HMGB1和VE-cadherin水平的变化与突发性耳聋病情严重程度密切相关。     

突发性耳聋预后的多因素分析

目的：探讨突发性耳聋发病时间、年龄、是否伴发眩晕、耳聋类型对疗效的影响。方法：对听力损失程度、病程长短、发病年龄不同以及有无伴随眩晕和各种听力曲线类型的110例突发性耳聋患者,治疗上以扩张周围血管、神经营养药为主,辅助以吸氧治疗,观察上述因素与疗效的关系。结果：病程小于3d内就治的轻中重度耳聋患者有效率92.1%;起病3-7d就治者有效率为86.3%;7d-1月就治者有效率为46.4%。从年龄上看,45岁之内者有效率83.3%;46-60岁者有效率70.0%;大于60岁以上者有效率33.3%。伴有眩晕者有效率42.8%;不伴眩晕者有效率86.5%。听力曲线平坦型的有效率73.8%,上升型的有效率100%,下降型的有效率62.9%,全聋型有效率27.8%,其他型的有效率66.7%。结论：突发性耳聋的疗效与开始治疗时间成正比,越早疗效越好、反之越差。中青年患者治疗效果佳。不伴眩晕的突发性耳聋患者疗效明显好于伴眩晕者。听力曲线呈上升型的预后较好,全聋型预后最差。     

突发性耳聋预后的相关因素探讨

目的：探讨影响突发性耳聋预后的相关因素。方法286例突发性耳聋患者治疗前和治疗后进行纯音听阈测试对比,探讨影响预后的相关因素。结果突发性耳聋预后与患者的发病时间、年龄大小、听力损失情况、有无眩晕、高血压、糖尿病及焦虑情绪有关,而与性别无关。结论突发性耳聋患者发病时间越长、年龄越大、听力损失越重,治疗预后越差。听力图中,高频型和水平型比中频型和低频型预后差,全聋型最差。不伴眩晕、无高血压高血脂糖尿病、无焦虑情绪的突发性耳聋患者疗效明显好于伴眩晕、有高血压高血脂糖尿病、有焦虑情绪患者。     

Reversible sensorineural hearing loss after non-otological surgery under general anaesthetic

Acute sensorineural hearing loss can occur after both otolaryngological and non-otolaryngological procedures. The mechanism of such hearing loss remains unproved; but nitrous oxide has been implicated and where used, attendants should be aware of its potential damage to hearing. It is essential that patients with sudden hearing loss are identified as soon as possible as the recovery rate had been shown to be higher in those who presented early; and as our case demonstrates, complete recovery is possible. Anaesthetists, non-otolaryngological surgeons, and ward nurses must be aware of this early postoperative complication if appropriate treatment is to be instituted.     

Use of intratympanic steroid as a primary treatment for sudden sensorineural hearing loss

Dramatic nature of sudden sensorineural hearing loss sets it apart from most of the conditions, which the otologists face in their practice. It has a reported incidence of 5-20/1,00,000 of population with involvement of both sexes in any age group. Exact aetiology of the disease is not known and most of the cases are idiopathic. Treatment policy differs from centre to centre. This prospective study with intratympanic steroid injection as a primary treatment with or without oral corticosteried therapy results 64% success rate with average hearing gain of 25 dB.     

Oral steroid treatment for idiopathic sudden sensorineural hearing loss

Objectives:

To describe the efficacy of long-term oral steroids in idiopathic sudden sensorineural hearing loss (ISSHL), and to explore potential prognosis factors, the relationship of hearing recovery outcome, and the recovery time-course in ISSHL.

Methods:

In this retrospective study, we analyzed 215 cases diagnosed with idiopathic unilateral sudden deafness between January 2003 and December 2012 at a regional hospital in southern Taiwan. All of them received oral steroid therapy and were followed for at least 3 months.

Results:

Young age, the presence of no other disease (diabetes, hypertension, or cardiovascular disease), treatment within 7 days of the onset of ISSHL, mild hearing loss, and audiograms with ascending curves had a statistically significant better hearing recovery. The average pure-tone audiometry (PTA) was 67.8±23.9 dB initially, and was improved between one month (51.6±28.7 dB) and 2 months post treatment (49.7±28.6 dB). The average last-visit PTA was 49.9±29.2 dB.

Conclusion:

Approximately one third of patients had full recovery in hearing, one third had partial recovery, and approximately one third did not recover from hearing loss. In addition, the hearing level remained relatively stable following 2 months of treatment. More than 2 months of oral steroid therapy for ISSHL is not recommended because no additional benefits were evidenced.Idiopathic sudden sensorineural hearing loss (ISSHL) is defined as a sensorineural hypoacusis of at least 30 dB over 3 consecutive speech frequencies, occurring within 3 days. It is considered to be an otologic emergency, and the incidence has been estimated to range from 3.9 to 27.5 per 100,000 persons per year.1 Although the exact cause is still unknown, it has been hypothesized to be caused by viral infection of the labyrinth or cochlear nerve, vascular insult, intra labyrinthine membrane rupture, and autoimmunity.2 Owing to the variations in the etiopathogenesis of ISSHL, different therapeutic strategies have been developed. Steroids or in combination with vasodilators, plasma expanders, diuretics, anticoagulants, antiviral, vitamins, cytotoxic medications, hyperbaric oxygen, stellate ganglion block, and inhaled carbogen, have become the most widely accepted treatment options.2-7 However, the length of oral steroid therapy had not been well established. Most of the studies reported the length of steroid therapy ranging between 5-24 days.2-7 Although little is known about the time course of hearing loss for most patients, improvement in hearing can be anticipated only during the first 1-2 months. Therefore, this study investigated progression in recovery from sudden hearing loss, and the optimal treatment duration with oral steroids.     

高压氧配合天眩清治疗突发性耳聋疗效观察

目的探讨高压氧配合天眩清治疗突发性耳聋的临床疗效.方法随机将150例突发性耳聋患者分为3组:单纯高压氧组、高压氧 天眩清组和单纯药物组,每组50例,观察临床疗效.结果高压氧 天眩清组的总有效率为96.0%,单纯高压氧组的总有效率为84.0%,而单纯药物组总有效率仅为62.0%,各组均有一定疗效,高压氧 天眩清组的痊愈率为36.0%,统计学处理有显著差异(P＜0.05).结论高压氧 天眩清组治疗总疗效优于其它两组,不管是在听力恢复程度、治疗时间长短、病程以及听力曲线改变上,高压氧 天眩清组的治疗效果均更优,无论听力损失程度有多重、病程有多长以及伴低频型听力曲线改变时均不应放弃高压氧为主的综合治疗方案.     

突发性聋伴眩晕患者血管损伤因素相关检查结果的分析

目的 总结突发性聋伴眩晕四种听力类型患者的临床特点,分析与血管损伤因素相关检查的临床价值及意义,了解血管因素在突发性聋伴眩晕发病机制中的作用.方法 收集我院2015年10月至2017年4月住院治疗的突发性聋伴眩晕病例,按听力曲线类型分成低频下降型、高频下降型、全频下降型、全聋型4组,分析其颅多普勒(TCD)、颈部血管彩色多普勒超声、MRI检查结果异常的分布情况和血浆同型半胱氨酸(HCY)水平.结果 突发性聋伴眩晕病例中全聋型占35.7％、高频听力下降型24.5％,低频听力下降型20.4％,平坦下降型19.4％.血管相关检查结果显示,血浆同型半胱氨酸异常检出率为83.7％,MRI为67.3％,颈部彩超为52.0％,TCD为17.3％.低频下降型患者血管相关检查异常率明显低于其他类型患者,差异有统计学意义(P＜0.05).结论 突发性聋伴眩晕病人中,低频下降型血管因素影响较小.同型半胱氨酸和MRI检查是突发性聋伴眩晕病人血管损伤性因素的敏感指标.     

甲泼尼龙鼓室内注射与全身应用在分型治疗特发性突发性聋的疗效分析

目的： 观察甲泼尼龙鼓室内注射与全身应用治疗不同分型特发性突聋的疗效。方法： 选取单耳特发性突聋患者167例,低中频下降型47例,中高频下降型42例,平坦型15例,全聋型63例。各型均采用随机数字表法分为2组：全身给药组（84耳）,鼓室给药组（83耳）,对各型患者有效率及治愈率分组进行分析。结果：鼓室内注射组低中频下降型治愈率比中高频下降型（P〈0.05）、全聋型（P〈0.05）高。鼓室内注射组低中频下降型治愈率较对照组高（P〈0.05）,其余三型间差异无统计学意义。结论： 低中频下降型ISSHL经鼓室内注射甲泼尼龙治疗比全身性给药效果更佳,其它三型如患者无激素应用禁忌建议首选全身用药。