突发性耳聋预后影响因素分析

目的探讨影响突发性耳聋预后转归的相关因素。方法回顾性分析89例突聋患者的临床资料,对性别、年龄、初诊时间,是否合并高血压、糖尿病,有无眩晕,发病耳别,听力损伤类型及分级等可能与突发性耳聋预后相关的因素进行观察和分析。结果初诊时间越短、听力损伤程度越轻、不伴有眩晕和听力曲线分型为上升型者预后较好。结论应根据突发性耳聋患者的发病时间、耳聋程度、听力曲线类型及是否伴有眩晕分析患者的预后并做到早发现、早治疗。     

低频下降型突发性耳聋预后的相关因素分析

[目的]分析低频下降型突发性耳聋预后的相关因素.[方法]回顾性分析延边地区59例低频下降型突发性耳聋患者的临床资料,其中男性20例,女性39例;平均年龄为45.96岁.所有患者均接受相同的治疗方案,观察并记录疗效.采用单因素及多因素方法分析年龄、性别、民族、发病时间、耳鸣、眩晕、高血压及糖尿病与听力恢复程度的相关性.[结果]59例患者中治愈39例(66.10%),有效10例(16.95%),无效10例(16.95%),总有效率为83.05%.年龄因素与疗效呈负相关(P<0.05),即年龄越大预后越差;性别与民族因素与疗效无显著相关性(P>0.05);发病时间与疗效间有显著相关性(P<0.05),即发病时间越早预后越好;是否伴有耳鸣与疗效间无显著相关性(P>0.05);是否伴有眩晕与疗效间有显著相关性(P<0.05),伴有眩晕者预后差;高血压及糖尿病与疗效间有显著相关性(P<0.05).[结论]年龄、发病时间、是否伴有眩晕、高血压及糖尿病是影响突发性耳聋预后的相关因素.     

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。     

突发性耳聋继发良性阵发性位置性眩晕的相关发病因素分析

目的：回顾性分析继发于突发性耳聋的良性阵发性位置性眩晕（benign paroxysmal positional vertigo，BPPV）患者的临床资料，并探讨其可能的发病因素。方法：观察2012年12月至2016年12月于我院耳鼻咽喉科门诊及病房就诊的240例突发性耳聋患者继发BPPV的发病情况，进行相关发病因素的调查。结果：本组突发性耳聋继发BPPV者，男女性别之间差异显著（χ2=9.898，P=0.002）。不同年龄分组中3组组间差异显著（χ2=13.145，P=0.001）。240例突发性耳聋患者具有高血压、糖尿病两者中至少1种疾病者45例，据合并或不合并高血压或糖尿病，将突发性耳聋继发BPPV者分为两组，两组间有差异显著（χ2=15.168，P=0.001）。按听力损失程度分组，39例继发BPPV者患者听力损失均为中重度和重度耳聋，其中中重度突聋患者继发BPPV者25例，重度突聋患者继发BPPV者14例，两组之间无显著性差异（χ2=1.533，P=0.216）。39例继发于突发性耳聋的BPPV，出现时间均在突发性耳聋发病后10 d内。继发于突发性耳聋的BPPV的手法复位效果与原发性BPPV相似，大多数都于1~2次就诊后治愈。 结论：对于继发于突发性耳聋的良性阵发性位置性眩晕，女性较男性发病高，中年人，听力损失程度重者，合并高血压、糖尿病等全身性疾病患者发病高。故推测女性，中年，听力损失程度重，合并高血压、糖尿病等全身性疾病可能是突发性耳聋继发BPPV的相关发病因素。继发于突发性耳聋的BPPV手法复位效果良好，故对于突发性耳聋继发眩晕者，应尽早施行。     

心理及其它因素对突发性耳聋患者预后的影响

目的:探讨突发性耳聋患者预后的相关因素,尤其是心理因素对预后的影响。方法:收集167例患者(170耳)的完整资料,对性别、年龄、就诊时间、听力损失程度、听力曲线类型、有无伴发眩晕及心理因素进行统计学分析,采用x2检验判定与预后的相关性。结果:患者的性别、听力曲线类型与预后无相关性,P>0.05;患者的就诊时间、听力损失程度、眩晕及心理因素与疾病预后相关,P<0.05。结论:突发性耳聋患者的预后与多种因素相关,心理因素作为一个可变因素应引起临床医师的重视。     

影响突发性耳聋预后因素分析

突发性耳聋是指突然发生的、原因不明的感音神经性听力损失,患者的听力一般在数分钟或数小时（少数患者在3d内）内下降至最低点,而且同时或先后伴有耳鸣及眩晕.目前,临床上已开始关注影响突发性耳聋预后的因素.本文回顾分析我院近年来收治的突发性耳聋患者的临床资料,探讨年龄、发病至就诊时间以及治疗开始前听力损失程度对预后的影响,现报道如下.     

254例突发性耳聋预后的影响因素分析

目的 探讨突发性耳聋预后的影响因素.方法 收集2017-2020年于我科住院的254例不同年龄及不同听力损失的突发性耳聋患者,分析性别、患耳侧别、血脂、年龄、就医时间、听力下降曲线类型、是否伴眩晕等与预后之间的相关性,比较分析不同年龄组患者的预后.结果 254例单耳突发性耳聋患者治疗总有效率为61.42％,12～40岁...     

突发性耳聋预后相关因素探讨

目的：探讨突发性耳聋预后的相关因素。方法：通过对188例突发性耳聋临床病例的回顾性分析，选择18项可能影响预后的因素，应用logistic回归分析逐步法分析(SAS8．2版)，探讨预后的相关因素。结果：预后与治疗前发病时问，是否伴发眩晕及地塞米松应用有相关性；与发病年龄，性别，患侧，治疗前听力损失程度，治疗时问，其他药物的应用，高压氧的应用等无相关性。结论：突发性耳聋的治疗应强调尽早施治及糖皮质激素的应用，伴发眩晕者预后不佳。     

突发性聋的预后与影响因素分析

目的:分析突发性聋的预后与常见影响因素的关系,为判断预后提供参考。方法:回顾性分析124例突发性聋患者的病历。治疗方法包括:改善微循环药物、皮质类固醇激素、神经营养类药物、高压氧治疗。对于伴有感染、高血压、糖尿病等疾病的患者,积极治疗相关疾病。疗程2～4周。统计相关影响因素包括:年龄、发病至初诊时间、听力损失程度、听力曲线类型、是否伴有眩晕与耳鸣等与疗效的关系。结果:痊愈30例,显效48例,痊愈率为24.19%,痊愈、显效率为62.90%。年龄<60岁各组与61～75岁组的疗效存在显著性差异(均P<0.01)。病程<7d、7～14d、>14d的3组疗效比较均差异显著(均P<0.05)。初诊听力损失轻、中度与重、极重度疗效差异显著(P<0.05)。初诊听力曲线上升型、平坦型与下降型的有效率比较存在显著性差异(P<0.05);不伴耳鸣或(和)眩晕的患者治疗有效率显著高于伴耳鸣或(和)眩晕的患者(P<0.01)。结论:>60岁突发性聋患者的疗效显著下降;发病后初诊时间越早疗效越好;发病>14d就诊疗效明显不佳;初诊听力曲线为平坦型和上升型、不伴耳鸣或(和)眩晕的患者预后好。     

糖尿病伴突发性耳聋23例临床治疗体会

目的观察药物和高压氧综合治疗伴糖尿病的突发性耳聋的疗效。方法收集23例伴糖尿病的突发性耳聋患者,均给予综合治疗,连续2～3个疗程。结果痊愈7例(30.4.%),显效12例(52.2%),无效4例(17.4%),总有效率82.6%。起效时间>15 d。结论伴有糖尿病的突发性耳聋,一旦确诊,即应早期采用综合治疗,单一用药效果欠佳。影响疗效的因素有:就诊时间、发病年龄、糖尿病控制情况、听力损失情况、有无眩晕、耳鸣等伴随症状。     

特发性突耳聋患者外周血内皮素的变化及其意义

目的通过对特发性突聋（ISSHL）患者外周血内皮素（ET）的测定,探讨ET在ISSHL中的作用。方法对60例ISSHL患者治疗前后以及56例健康者采用放射免疫法测定血浆ET。结果 ISSHL患者ET水平明显高于健康对照者（P〈0.01）,并同耳聋程度呈线性关系（r=0.771,P〈0.01）;伴有眩晕的ISSHL患者ET含量高于不伴有眩晕的ISSHL患者（P〈0.01）;治疗有效组治疗后的ET水平明显降低（P〈0.01）,同健康对照组比较无明显差异（P〉0.05）;治疗无效组治疗后的ET水平也有明显降低（P〈0.01）,但仍然高于健康对照组（P〈0.01）。结论 ET对ISSHL患者听力减退、眩晕发作以及治疗效果具有一定的影响。血浆ET水平可间接反映ISSHL的病情和预后,及时检测ET对于预防和治疗ISSHL具有指导价值。     

特发性突聋患者外周血NO的变化

目的:通过特发性突聋(ISSHL)患者血中一氧化氮(NO)的测定,探讨NO在ISSHL中的作用.方法:对60例ISSHL患者治疗前后以及56例健康者采用硝酸还原酶法检测血清NO.结果:ISSHL患者NO水平低于健康对照者,但只有听力在41-60dBHL病人的NO浓度同健康对照组有显著差异(P<0.01);伴有眩晕和不伴...     

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.     

Hyperbaric Oxygen Treatment Improves Hearing Level via Attenuating TLR4/NF-κB Mediated Inflammation in Sudden Sensorineural Hearing Loss Patients

Objective Hyperbaric oxygen treatment(HBOT) has demonstrated efficacy in improving hearing levels of patients with idiopathic sudden sensorineural hearing loss(ISSHL); however, the underlying mechanisms are not well understood. HBOT alleviates the inflammatory response, which is mediated by Toll-like receptor(TLR) 4 and nuclear factor(NF)-κB. In this study we investigated whether HBOT attenuates inflammation in ISHHL patients via alteration of TLR4 and NF-κB expression.Methods ISHHL patients(n = 120) and healthy control subjects(n = 20) were enrolled in this study.Patients were randomly divided into medicine group treated with medicine only(n = 60) and HBO group receiving both HBOT and medicine(n = 60). Audiometric testing was performed pre-and posttreatment. TLR4, NF-кB, and TNF-α expression in peripheral blood of ISSHL patients and healthy control subjects was assessed by ELISA before and after treatment.Results TLR4, NF-κB, and TNF-α levels were upregulated in ISSHL patients relative to healthy control subjects; the levels were decreased following treatment and were lower in the HBO group than that in the medicine group post-treatment(P 0.05 and P 0.01).Conclusion HBOT alleviates hearing loss in ISSHL patients by suppressing the inflammatory response induced by TLR4 and NF-κB signaling.     

听力损失与突发性聋预后的关系

目的:探索听力损失对突发性聋预后的影响。方法:对146例(167耳)突聋患者的临床资料进行回顾性分析,应用SAS统计软件对纯音听阈情况与预后的关系进行统计学处理。结果:单因素分析显示,初诊时听力损失曲线为全聋型,纯音高频听阈(4 000 Hz及8 000 Hz)损失较重,高频听阈(4 000 Hz+8 000 Hz)大于低频(250 Hz+500 Hz)听阈的患者预后不佳;多因素分析显示,8 000 Hz的听阈水平与预后关系最为密切,其次为4 000 Hz听阈及听力损失类型。结论:从单、多因素分析的结果可以看出,对突聋应采用多因素逐步分析的方法进行研究,以使预后和疗效评估更具准确性和客观性;高频听力损失程度是突发性聋预后的一个可靠评估因素。     

突发性耳聋60例临床分析

目的探讨突发性耳聋的预后影响因素。方法 60例(60耳)突发性耳聋患者均在声频治疗基础上辅以药物治疗,根据发病年龄、就诊时间、伴随症状、耳聋程度对治疗前后听力检查结果进行分析。结果年轻人突发性耳聋治愈率高于老年人,越早治疗听力预后越好。结论耳聋的改善程度受病因、病程影响较大,早诊断早治疗是提高突发性耳聋治愈率的关键。     

突发性聋患者外周血白细胞水平与预后的关系

目的:分析突发性聋患者外周血白细胞水平与预后的关系。方法:按白细胞水平对突发性聋135例分组分析,并探讨其发生机制。结果:(1)白细胞升高组与正常组突发性聋患者的听阈水平无统计学差异(P>0.05);(2)白细胞与中性粒细胞计数均高的突发性聋组的有效率明显低于白细胞正常组(P<0.05)。结论:突发性聋患者外周血中白细胞明显增高,提示其疗效明显低于白细胞数正常者。     

影响突聋疗效的相关因素分析

目的：探讨突聋的发病时间、年龄及眩晕对疗效的影响。方法：收集听力损失程度不同、病程长短不同、发病年龄不同及伴随有无眩晕的突聋患者150例，采用以前列腺素E1为主药，以扩血管、神经营养药为辅助治疗，观察上述因素与疗效关系，治疗前后行听力学检查对照。结果：病程小于2周内就治的轻中重度耳聋患者其有效率达97．22％；起病大于3个月就治者，其有效率为58．33％。从年龄看45岁之内者有效率为91．91％；46～60岁者有效率为85．36％；大于60岁以上者有效率75．00％。伴随症状看，伴有眩晕者有效率60．86％；不伴眩晕者有效率94．48％。结论：突聋的疗效与治疗时间成正比应越早疗效越好、反之越差；以中青年发病者治疗效果佳，伴眩晕的疗效差，不伴眩晕的疗效好。     

单侧突发性聋伴或不伴眩晕与听力的关系临床分析

目的：探讨突发性聋伴或不伴眩晕与预后的相关性。方法：176例单侧耳突发性聋，治疗前病程在10d以内，同一治疗方案及疗程，观察伴或不伴眩晕患者的疗效。结果：突发性聋伴眩晕者多表现为重度或高频听力损失，此两组听力损失型伴或不伴眩晕疗效均不满意，而不伴眩晕者多表现为低频或平坦型听力损失，且大多可以获得满意疗效。结论：突发性聋伴或不伴眩晕与预后无相关性，疗效与治疗起始听力损失的曲线类型有密切关系。