伴和不伴眩晕突聋患者疗效比较

目的观察伴和不伴眩晕突聋患者的疗效差异。方法选取2008～2010年收治并随诊1年后的突聋病例为研究对象,其中不伴眩晕突聋患者43例,伴眩晕突聋患者53例,两组患者均给予能量合剂及银杏叶提取物静脉滴注,1次/天;甲钴胺注射液0.5mg、地塞米松15mg加入5%葡萄糖250ml静脉滴注,1次/天,连用3天,若有效再用2天后停用激素;巴曲酶5BU加入0.9%氯化钠注射液静脉滴注,隔日一次,用3次,比较两组疗效。结果治疗前伴眩晕突聋组平均纯音听阈(58.43±19.31dB HL)与不伴眩晕组(58.64±20.81dB HL)差异无统计学意义(P>0.05),治疗后不伴眩晕突聋组的平均听阈(36.03±20.85dB HL)明显低于伴眩晕突聋组(40.12±22.21dB HL)(P<0.05)。伴眩晕突聋组总有效率为66.04%(35/53),不伴眩晕突聋组总有效率为55.81%(24/43),两组总有效率差异无统计学意义。随访一年,不伴眩晕突聋组和伴眩晕突聋组都有所好转,两组总好转率差异无统计学意义(P>0.05)。结论本组患者中,伴和不伴眩晕突聋者总效率差异无统计学意义,但治疗后伴眩晕突聋组听阈下降不如不伴眩晕组。     

特发性突聋伴眩晕对患者预后的影响

目的 探讨特发性突聋患者预后不良与眩晕的关系。方法 将我院收治的107例特发性突聋(ISHL)患者分为不伴眩晕组、伴眩晕组,对两组的治疗效果进行比较分析。结果 治疗有效率,不伴眩晕组为81%,伴眩晕组为51%,两者比较差异有统计学意义(P<0．05)。结论 一般ISHL预后尚好,伴有眩晕的ISHL预后较差。     

伴或不伴眩晕的突聋疗效的分析

突发性聋 (突聋 )是否伴眩晕 ,对其预后的影响文献中报道不一。本文报告 1986年 7月～ 1997年 7月我科收治的发病 2周内的突聋患者 92例 ,分析伴或不伴眩晕的两类突聋患者经高压氧加常规药物综合治疗的疗效。1　资料与方法1 1　临床资料　 92例突聋患者中男性 6 4例 ,女性 2 8例。男性中伴眩晕 2 1例 ,女性中伴眩晕 12例。发病 1周内入院5 8例 ,伴眩晕 2 5例 ,无眩晕 33例。发病第 2周人院 34例 ,伴眩晕 8例 ,无眩晕 2 6例。 92例患者均符合 1996年上海会议制定的突发性聋的诊断标准。92例均经颅神经检查及头颅内听道影像检查无异常 ,纯音听…     

眩晕和年龄与突聋患者听力损失的关系

目的探讨眩晕和年龄与突聋患者听力损失的关系。方法根据突聋的发病年龄和是否伴眩晕分组,回顾性分析1999~2004年住院的202例(219耳)突聋患者的纯音测听结果。结果<14岁患者(12耳)听力损失较14~60岁患者(184耳)和>60岁患者(23耳)严重;伴眩晕患者(65耳)听力损失较不伴眩晕患者(154耳)严重。结论儿童及伴眩晕的突聋患者听力损失较严重。     

突发性聋伴发眩晕的初步探讨

目的:探讨突发性聋(突聋)伴发眩晕的病变类型及发病机制.方法:详细记录住院治疗的121例突聋患者性别、年龄、就诊时病程、听力损失情况、听力图类型、发病前后的眩晕情况及预后.按照中华医学会突聋多中心研究突聋分类,依照纯音测听图将突聋分为低频型、高频型、中频型、平坦型、全聋型5种类型,分别计算眩晕在不同类型突聋中的比例,并将各组的眩晕比例进行统计学分析.结果:121例患者中,伴发真性及假性眩晕的患者有45例(37.2%);高频型突聋、低频型突聋、平坦型突聋及全聋型突聋患者中眩晕的发生率分别为42.9%,47.1%,23.6%和51.4%;不同突聋类型眩晕的发生率采用卡方检验,分别两组进行卡方检验,低频组、高频组及全聋组眩晕的发生率没有差别,平坦组眩晕发生率较其他3组低(P<0.05).121例患者中,伴发真性眩晕的患者有23例(19.0%);不同类型突聋之间眩晕的发生率没有差别.结论:通过对不同眩晕类型及不同听力学类型的突聋患者的病情分析,进一步验证了血管因素和病毒感染因素在不同突聋类型患者中的作用.通过对突聋伴眩晕患者眩晕情况的探讨,加深了对突聋的发病机制的认识,改进了耳源性眩晕的诊断治疗.     

突聋伴眩晕患者前庭诱发肌源性电位的临床研究

目的通过观察突发性聋伴眩晕患者前庭诱发肌源性电位的引出率及各参数,探讨前庭诱发肌源性电位对突聋伴眩晕患者内耳损伤情况的诊断及预后评估。方法收集50例单耳突聋伴眩晕的患者,50例单耳突聋不伴眩晕患者及60例正常听力人作为对照组,分析对比o VEMP及c VEMP的引出率和各参数变化。结果引出率:病例组患耳、对侧耳、突聋不伴眩晕组及正常对照组o VEMP引出率分别为24%、42%、48%、100%,c VEMP引出率分别为:56%、74%、64%、100%,病例组患耳和对侧耳相比,o VEMP及c VEMP引出率差异无统计学意义(P>0.05),病例组患耳及对侧耳分别和正常对照组比较,o VEMP及c VEMP引出率均明显降低(P<0.05),病例组患耳o VEMP引出率明显低于突聋不伴眩晕组(P<0.05)。o VEMP:病例组患耳、对侧耳、突聋不伴眩晕组及正常对照组的各参数(N1潜伏期、P1潜伏期、P1-N1振幅)两两比较,组间不对称比(AR)比较,差异均无统计学意义(P均>0.05)。c VEMP:病例组患耳、对侧耳、突聋不伴眩晕组及正常对照组的各参数比较,患耳及对侧耳P1-N1振幅比突聋不伴眩晕组及正常对照组均明显降低(P<0.05),病例组AR比正常对照组明显增高(P<0.05),o VEMP及c VEMP结果与听力损失分型、听力损失程度分级无明显相关性(P>0.05),但与疗效分级明显相关(P<0.05)。结论突聋伴眩晕患者存在同侧及对侧的椭圆囊(前庭上神经)和球囊(前庭下神经)传导功能障碍,前庭诱发肌源性电位为突聋伴眩晕患者耳石器及前庭神经功能评估提供客观依据。     

突发性聋伴良性阵发性位置性眩晕的预后分析

目的探讨突发性聋伴良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)患者的预后。方法回顾性分析105例突发性聋患者的临床资料,根据有无伴眩晕以及体位试验的结果分为三组:突发性聋伴BPPV组(13例)、突发性聋伴非BPPV眩晕组(27例)、突发性聋不伴眩晕组(65例),比较三组患者治疗前后的听力情况。结果突发性聋伴BPPV组与突发性聋伴非BPPV眩晕组听力损失较突发性聋不伴眩晕组重,且预后相对较差。结论 BPPV是突发性聋的不良预后因素,耳石手法复位对BPPV治疗有效。     

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...     

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。     

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。     

突发性聋伴发良性阵发性位置性眩晕的临床特点及疗效观察

目的　探讨突发性聋伴发良性阵发性位置性眩晕（benign paroxysmal positional vertigo,BPPV）的临床特点,观察其疗效。方法　观察2012年10月～2014年6月耳 鼻咽喉科收治的36例突发性聋伴发BPPV发病情况,并与同期原发性BPPV患者40例及突发性聋不伴眩晕患者40例进行疗效比较。结果　伴发BPPV的36例突发性聋患者,受累半规管均与突发性聋发病侧一致,其中水平半规管BPPV 6例,占16.7%（6/36）;后半规管BPPV 27例,占75.0%（27/36）;混合管BPPV 3例,占8.3%（3/36）。36例患者出现BPPV的时间均在突发性聋发病后数小时至数天（＜10天）发生。突发性聋伴发BPPV组1次治愈率明显低于原发性BPPV组,但两种治疗方法的总治愈率均为100%。不伴眩晕突发性聋组的痊愈率、显效率及有效率均高于伴发BPPV组。结论　伴发于突发性聋的BPPV以后半规管多见,与原发性BPPV经耳石复位治疗后均可取得较好疗效。而不伴眩晕的突发性聋其疗效优于伴发BPPV的突发性聋。     

Caloric tests in clinical practice in benign paroxysmal positional vertigo

Background: The value of caloric tests in benign paroxysmal positional vertigo (BPPV) patients is unclear.

Objectives: To analyze the features and clinical significance of caloric tests in BPPV patients.

Materials and methods: About 2192 patients (256 BPPV and 1936 non-BPPV) who complained of dizziness triggered by movement, accompanied by the symptom of hearing loss or a history of vertigo, participated in this prospective clinical study. All subjects received a caloric test, 213 BPPV patients underwent follow-up for at least 6 months after canalith repositioning procedures (CRPs).

Results: (1) The abnormal canal paresis (CP) prevalence of BPPV was 57%. (2) The curative rate of single CRP decreased during follow-up from 90.1% after 7 days to 61% after 6 months and was significantly lower in patients with (54.1%) than in those without (70.1%) an abnormal CP at 6 months post-treatment (p?=?.01). (3) The recurrent rate was significantly higher in BPPV patients with abnormal CP (25.2%) than with normal CP (12.5%; p?=?.017).

Conclusions and significance: Patients with abnormal CP needed more CRPs and were more prone to relapse. The value of the caloric test in treatment planning and predicting recurrence in BPPV patients should be emphasized.     

The relationship between benign paroxysmal positional vertigo and thyroid autoimmunity

Conclusion: Although there have been few studies concerning BPPV and thyroid autoimmunity and a positive relation was found between them, this study didn’t find any relation between BPPV and thyroid autoimmunity. IT is thought that further large-scale studies must be done to clarify the relation. Objectives: Benign paroxysmal positional vertigo (BPPV) consists of ～ 20% of vestibular disorders. Self-limited rotatory nystagmus with positional vertigo are the main findings of BPPV. Although canalolithiasis theory was confirmed by demonstrating freely floating debris in the endolymph of the posterior semicircular channel in following studies, currently, the etiology hasn’t be explained totally. This study investigated the relation of BPPV and thyroid autoimmunity evaluated via measurement of serum thyroid autoantibodies. Method: Fifty patients (37 female, 13 male) with BPPV (BPPV group), 52 patients (40 famale, 12 male) with non-BPPV vertigo (non-BPPV group) and 60 otherwise normal control (38 female, 22 male) samples were enrolled in the study. All samples of BPPV, non-BPPV groups and controls had undergone a cochleovestibular test following thorough ENT examination. After blood samples were drawn from each subject, thyroid-stimulating hormone (TSH), anti-thyroid peroxidase antibody (TPO-Ab) and anti-thyroglobulin antibody (TG-Ab) levels were measured accordingly. Results: In the study, eight patients of the BPPV group (16%) had a high thyroid antibody level. In the non-BPPV group, six patients (11.5%) had elevated thyroid antibodies. In the control group, 15 patients (25%) had elevated thyroid antibodies. TSH values of all subjects were detected to be within normal range. No statistical difference was found between the groups with respect to TG-Ab and TPO-Ab values (p-values = 0.729 and 0.812, respectively).     

中青年突发性耳聋的临床特征及预后分析

目的 探究中青年突发性耳聋的临床特征并分析其预后情况。方法 选取2020年6月—2022年5月就诊于广州医科大学附属第四医院耳鼻咽喉科的147例突发性耳聋患者,根据患者年龄划分,将18～55岁患者作为实验组(n=74),将56～80岁患者作为对照组(n=73),回顾性分析两组突发性耳聋患者的临床资料,比较两组临床特征及预后。结果 两组患者一般情况经比较无统计学意义(P>0.05);耳鸣、耳闷、眩晕等临床症状比较,两组差异无统计学意义(P>0.05);听力损失分级、分型及临床疗效比较,实验组听力损失较轻,低频下降型相对较多见,临床治疗总有效率高,差异均具有统计学意义(P均<0.05);高血压、糖尿病、脑血管疾病等患者突发性耳聋患病率,实验组均低于对照组(P均<0.05)。结论 中青年突发性耳聋患者具有基础疾病少、听力损伤较轻、低频下降型相对多见等临床特征,通过临床积极救治,往往疗效显著,预后良好。     

继发突发性聋的良性阵发性位置性眩晕

目的 回顾性分析继发于突发性聋的良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的临床特点,并探讨该病的诊断与治疗特点.方法 突发性聋伴BPPV患者19例,全部进行了手法复位治疗,并评价其治疗效果.结果女性患者63.2％,男性36.8％;本组BPPV均继发于突发...     

不同时机鼓室内注射糖皮质激素治疗重度以上突发性聋的疗效分析

目的 观察全身联合不同时机鼓室内注射糖皮质激素治疗重度以上突发性聋的疗效,探讨鼓室内注射时机,分析影响重度以上突发性聋预后的因素。方法 回顾性分析108例重度以上突发性聋患者的临床资料及治疗效果,其中全身联合初始鼓室组64例,全身联合延后鼓室组44例;对两组患者出院时与随访时疗效分别进行比较,并分析治疗有效组和无效组临床特征。结果 出院时和随访时两种治疗方案平均听阈、平均听阈改善值、总有效率比较差异均无统计学意义（P均>0.05）,两种治疗方案痊愈率比较差异具有统计学意义（P<0.05）。两种治疗方案治疗前与出院时、治疗前与随访时分别比较差异均具有统计学意义（P均<0.001）。108例患者中,有效83例（76.9%）,伴眩晕者治疗有效率低（P<0.05）,治疗有效率与患者初始听阈损失程度（P<0.05）及听力曲线类型（P<0.05）相关,与年龄、性别、侧别、是否伴发耳鸣均无明显相关性（P均>0.05）。结论 对于重度以上突发性聋,听力损失程度、曲线类型、是否伴发眩晕与预后相关,治疗上建议尽早全身联合局部应用糖皮质激素。     

Recurrent benign paroxysmal positional vertigo in two DFNB16 siblings: A CARE case report

IntroductionDeletions or variants of the STRC gene coding for stereocilin cause congenital bilateral mild-to-moderate sensorineural hearing loss without vestibular disorder: DFNB16. Stereocilin is a protein present in vestibular kinocilia embedded in the otoconial membrane of the utricular macula. Benign paroxysmal positional vertigo (BPPV) is a rare form of vertigo in children. The present study reports recurrent positional vertigo in two DFNB16 siblings.ObservationTwo patients, 10 and 15 years old, presented with recurrent disabling positional vertigo episodes, triggered by turning over in bed, with a falling sensation. The diagnosis of right posterior canal BPPV was confirmed on Dix-Hallpike maneuvers in one of the patients. Variations in the response of ocular vestibular-evoked myogenic potentials were observed. Probable BPPV was diagnosed in the second patient. Their other two siblings did not have hearing loss or vertigo.ConclusionThe absence of stereocilin due to homozygous deletions of the STRC gene in DFNB16 patients can cause vestibular dysfunction, including BPPV.     

Is BPPV a Prognostic Factor in Idiopathic Sudden Sensory Hearing Loss?

Objectives

The prognostic significance of vertigo in patients with idiopathic sudden sensorineural hearing loss (SSNHL) remains a matter of debate because vertigo is associated with many different vestibular disorders. The purpose of this study is to determine the role of benign paroxysmal positional vertigo (BPPV) as a prognostic factor in patients with SSNHL.

Methods

We conducted a retrospective study of 298 patients with SSNHL. Hearing outcomes were evaluated by assessments of pre-treatment hearing and hearing gain. Comparative multivariate analyses between prognostic factors and hearing outcome were conducted.

Results

Thirty-eight (12.7%) SSNHL patients were found to also have BPPV. BPPV showed significant negative prognostic factors in hearing outcome on multivariate analysis (odds ratio, 0.15). In comparison to average pure tone audiometry (PTA), patients diagnosed with SSNHL with BPPV exhibited poorer hearing in pre- and post-treatment PTA compared to SSNHL without BPPV. Old age (>60 years), pre-treatment hearing, and canal paresis were significant outcome predictors.

Conclusion

BPPV in SSNHL patients, representing definitive vestibular damage, was closely related to poor prognosis.     

Prognostic factors in sudden sensorineural hearing loss: a retrospective study using interaction effects

The prognostic significance of vertigo in patients with idiopathic sudden sensorineural hearing loss (SSNHL) remains a matter of debate.ObjectiveThis paper aims to verify the difference between a group with vertigo and a group without vertigo, and to analyze vertigo's validation as a prognostic factor in patients with SSNHL.MethodThis study involved 183 patients with SSNHL. A t-test was used to compare group A (SSNHL with vertigo, n = 31) and group B (SSNHL without vertigo, n = 152). Also we want to verify the interaction effects between vertigo and other prognostic factors using multiple regression analysis.ResultsThere was a significant difference between group A and group B: the initial hearing level of group A was lower than group B, and their treatment onset was also shorter. In addition, vertigo itself didn't affect hearing improvement, but the interaction variable between vertigo and initial hearing level did affect hearing improvement significantly.ConclusionThe clinical characteristics of patients with vertigo did not directly affect hearing improvement with SSNHL; however, vertigo had an influence on SSNHL though its interaction with the initial hearing levels.     

New scoring system of an interview for the diagnosis of benign paroxysmal positional vertigo

Conclusion This study investigated a novel instrument to diagnose benign paroxysmal positional vertigo (BPPV).

Objective To develop a new scoring system of an interview for the diagnosis of BPPV.

Methods The answers to questions on dizziness and/or vertigo (D/V) (571 patients) were analyzed and the questions for which the answers differed significantly between the patients with and without BPPV were selected.

Results This study established an intensive questionnaire with a scoring system. It consists of the following questions: (1) Is rotary vertigo a characteristic of your D/V? (2) Is your D/V triggered when you roll your head over in a supine position? (3) Does your D/V disappear within 5 min? (4) Have you previously experienced hearing loss in one ear, or have you experienced hearing loss, tinnitus, or ear fullness with this D/V? One point each was given to an answer of ‘yes’ to questions (1) and (2). Two points were given to an answer of ‘yes’ to question (3). One point was subtracted upon an answer of ‘yes’ to question (4). When the total score was greater than two points, the patient was diagnosed with BPPV. The sensitivity of the diagnosis of BPPV by this scoring system was 81% and the specificity was 69%.