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。     

突发性聋合并类风湿性关节炎患者的特征及疗效分析

目的:探讨突发性聋(突聋)合并类风湿性关节炎(RA)患者的临床特征及疗效,并分析RA病程对突聋听力预后的影响.方法:收集43例(46耳)合并RA的突聋患者(RA组)的临床资料,并选择同时期住院治疗的386例(400耳)未合并RA的突聋患者(非RA组)作为对照组,比较两组的临床特征及预后;同时根据RA病程长短将RA组患者...     

鼻咽癌放疗后突发感音神经性聋14例临床分析

目的 探讨鼻咽癌放射治疗后突发感音神经性聋患者的临床特点及疗效,以利临床诊治。方法 回顾性分析14例（15耳）鼻咽癌放疗后突发感音神经性聋患者的临床特点及疗效。结果 鼻咽癌放射治疗后突发感音神经性聋的患者中男10例、女4例,左耳10耳、右耳5耳,平均发生时间为放疗后6.6年,突聋前多存在听力损失。250、500、1000、2000、4000 Hz的平均听阈（听力级）：突聋耳为(78.5±24.7) dB,非突聋耳为(57.0±32.4) dB。突聋耳73.33％ (11/15)为感音神经性聋,26.67％为混合性聋(4/15)。12例合并放疗后并发症,至少1例存在后循环障碍。治疗总有效率为26.67％ (4/15),其中4例复发且再治疗无效。结论 鼻咽癌放疗后患者发生突发感音神经性聋的程度较重,疗效较差,易复发。其发病机制可能与放疗所致后循环障碍有关。     

儿童突发性聋患者的临床特征及预后分析

目的 分析儿童突发性聋(简称突聋)患者的临床特征及预后,为该病的临床诊治提供参考.方法 回顾性分析2008年1月～2016年10月确诊并治疗的23例(25耳)儿童突聋患者的临床资料,对所有患者的年龄、性别、耳别、就诊时间、病毒感染史、就诊时言语频率气导纯音听阈及听阈曲线类型、是否伴有耳鸣、眩晕、耳闷及治疗效果进行统计分析,并与同期住院治疗的202例(219耳)成人突聋患者进行对比.结果 本组儿童突聋患者占同期所有突聋患者的10.2％(23/225);儿童突聋患者就诊时平均听阈(87.7±16.1 dB HL)、全聋型比例(72.0％)、眩晕伴发率(52.2％)及病毒感染率(17.4％)均高于成人(分别为72.5±24.7 dB HL、44.7％、29.2％、3.5％),差异均有统计学意义(均为P＜0.05).治疗后儿童突聋患者与成人患者的总有效率分别为52.0％、46.6％,痊愈率分别为4.0％、14.2％,差异均无统计学意义(P＞0.05).结论 本组儿童突聋患者就诊时听力损失较重且常伴有耳鸣及眩晕,其听阈曲线以全聋型为主;疗效与成人突聋患者相当.     

耳后注射甲泼尼龙治疗合并代谢综合征的突聋伴持续性耳鸣的疗效分析

目的 研究耳后骨膜下注射甲泼尼龙在合并代谢综合征的突聋伴持续性耳鸣患者的疗效及对血糖、血压、甘油三酯水平的影响,探讨治疗合并代谢综合征的突聋伴持续性耳鸣有效方法.方法 选择2015年7月—2020年12月收治的66例合并有代谢综合征的突聋伴持续性耳鸣患者,随机分实验组和对照组.每组患者各33例,两组均治疗15 d,实验...     

伴自身免疫性疾病突发性聋患者的临床特征及预后

目的 分析突发性聋(突聋)合并自身免疫性疾病患者的临床特点及预后.方法 以2014年1月至2019年5月诊治的511例(511耳)突聋患者为研究对象,其中,合并自身免疫性疾病(autoimmune disease,AID)(AID组)56例,不合并AID(非AID组)455例,比较两组患者的临床特征及预后;同时,将AI...     

老年突发性聋64例临床观察

目的分析老年突发性聋患者的疗效。方法将126例突发性聋患者依据住院时实际年龄分为老年组(年龄≥60岁,64例64耳,其中单纯突聋组21例,突聋伴合并症组43例)和对照组(年龄<60岁,62例62耳),治疗前老年组平均听阈54.34±15.88 dB HL,对照组平均听阈53.81±14.43 dB HL,两组患者均采用金纳多30 ml静脉滴注,1次/天,治疗10天后复查听力,比较两组疗效。结果老年组总有效率为59.38%,对照组为75.81%,两组比较差异有统计学意义(χ2=3.87,P<0.05)。老年组中单纯突聋组总有效率80.95%,突聋伴合并症组总有效率为48.84%,差异有统计学意义(P<0.05)。结论老年突发性聋患者预后较差,与老年人血粘度增加及多合并高血压、糖尿病、高脂血症、冠心病等导致微循环障碍有关。     

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。     

研究突发性聋(突聋)伴眩晕患者的临床特点及预后影响

目的 分析突发性聋(突聋)伴眩晕患者的临床特点及预后影响。方法 于2020年11月-2021年10月开展研究,将本院收治的70例突聋伴眩晕患者纳入本次研究,对突聋并眩晕的临床特点进行分析,进行临床治疗效果评估,做好预后相关影响因素的分析。结果 突聋伴眩晕发病的原因包括感冒、情绪激动以及过度劳累、嗜烟、酗酒等;患者住院时间一般在(12.5±5.6)d左右,伴随症状为眩晕、头晕、听力下降、耳石症及耳鸣、耳周发麻、耳闷等;患者多合并多种基础疾病,包括高血压、糖尿病、高血脂及心脏病、脑梗死等;病变部位一般在左右侧半规管及病侧半规管;听力曲线分型中,以高频下降型居多,其次为低频下降型及平坦下降型、全聋型。经过系统化治疗,突聋伴眩晕治疗有效率为48.6%;伴随眩晕及耳石症、就诊时间超过14d以及听力曲线测试结果为高频下降型患者、耳蜗电图未引出、前庭功能失调都是导致治疗预后差的因素。结论 对突聋伴眩晕患者的临床特点及预后影响因素进行深入分析,有助于提升临床诊疗的针对性,有助于获得较好的预后。     

小儿突发性聋临床特征分析

目的探讨小儿突发性聋(突聋)的临床特点、疗效以及预后影响因素,指导临床治疗。方法回顾分析21例(24耳)儿童突聋患者临床资料,并与同期37例(39耳)成人突聋患者进行对比分析。结果小儿组7例有明确上呼吸道感染史,发病时伴耳鸣17耳(70.8%),伴眩晕9耳(37.5%),初诊时0.25~4kHz平均听力损失重度聋以上者23耳,占95.8%;治疗后痊愈5耳(20.8%),总有效率29.2%。成人组有上呼吸道感染史5例,占13.5%,初诊时0.25~4kHz平均听力损失重度聋以上23耳(59%),治疗后痊愈6耳(15.4%),总有效率41%。结论小儿突发性聋听力损失较成人重,预后较成人差。病毒感染可能是小儿突发性聋主要病因,初诊时听力损失水平、初诊时间与预后相关。     

三磷酸胞苷加地塞米松等综合治疗突发性聋的临床观察

OBJECTIVE: To investigate the effect of application of cytridini triphosphatis (CTP) combined with dexamethasone on sudden deafness. METHODS: Two-hundred and seven patients (312 ears) with sudden deafness were randomly divided into CTP group (n = 159 ears) and control group (n = 153 ears). Besides intravenous administration of CTP, another treatments in CTP group were the same as that in control group including hyperbaric oxygen, vasodilator, energy preparation such as ATP, CoA and dexamethasone (DXM). RESULTS: The hearing threshold was (75.56 +/- 30.24) dB HL in CTP group and (72.50 +/- 40.50)dB HL in control group (P > 0.05) before treatment. The average value of the hearing threshold after treatment was decreased by (50.08 +/- 21.47) dB HL in CTP group and (19.45 +/- 19.12) dB in control group(P < 0.05), respectively. CONCLUSION: The application of CTP combined with DXM can significantly improve the effect of treatment on sudden deafness and CTP may enhance the recovery rate in the patients with sudden deafness, which was much higher than that treated by the traditional methods. However, the mechanism of the effect of CTP coupled with DXM is still unknown and further study is necessary.     

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。     

脂肪组织压片修补中大型鼓膜穿孔52例临床分析

目的 探讨耳内镜下自体耳后皮下脂肪组织压片修补中大型鼓膜穿孔的临床疗效。方法 回顾性分析耳内镜下应用自体耳后皮下脂肪组织压片修补中大型鼓膜穿孔52例(52耳)患者的临床资料,观察鼓膜穿孔的愈合及听力改善情况。结果 随访6～12个月,52例均未出现面瘫、味觉减退等手术并发症。52耳中49耳穿孔完全闭合,总治愈率94.2% (49/52),平均听力提高(14.7±3.1)dB;其中,外伤性穿孔31耳,治愈率96.8% (30/31),平均听力提高(14.3±1.6)dB;慢性中耳炎陈旧性穿孔21耳,治愈率90.5% (19/21),平均听力提高(15.4±4.4)dB。结论 脂肪组织压片可用于修补中大型鼓膜穿孔,疗效可靠,愈合率高。此技术优于脂肪嵌入法,扩大了脂肪组织修补鼓膜穿孔的临床应用。     

鼻咽癌放疗后突发性聋18例

目的 探讨鼻咽癌放疗后突发性聋(突聋)的临床特征及预后,为该类疾病的临床诊治提供依据.方法 收集并分析18例鼻咽癌放疗后突聋患者的临床资料,包括年龄、性别、耳侧、病程、伴随症状、听力曲线类型、听力损失程度、放疗后突聋发病间隔以及听力预后.结果 18例均为单侧发病,左侧10耳(55.56％),右侧8耳(44.44％);其...     

病程超过3周的突发性聋患者的临床疗效分析

目的 了解对病程超过3周的突发性聋患者以糖皮质激素等药物进行治疗的意义.方法 对北京大学人民医院耳鼻咽喉科2002年11月至2010年7月住院治疗的48例(58耳)病程超过3周的突发性聋患者的临床资料进行同顾性分析.根据本次入院治疗前的听力曲线分为3组,分别采用不同的治疗方案,观察其疗效.以SPSS 17.0统计软件对数据进行分析,患者治疗前后纯音测听阈值采用t检验.结果 低频下降型(6耳)、高频下降型(22耳)、全频下降型(30耳)治疗后有效率分别为83.3%、31.8%、36.7%.病程≥1年的共12耳,其治疗有效率58.3%(7耳).全频下降型中本次治疗前气导听阈均值≥90 dB(听力级)的9耳,7耳(77.8%)治疗有效,其中3耳(33.3%)达到显效标准;本次治疗前气导听阈均值＜90 dB的患者21耳,其中3耳(14.3%)治疗有效.结论 病程超过3周的突发性聋患者仍有积极治疗的意义.其中低频下降型治疗有效率最高,高频下降型有效率最低,全频下降型有效率居中.病程≥1年的突发性聋患者经积极治疗仍有改善听力可能.全频下降型、听功能损失程度较重的患者,通过积极治疗获益较大.

Abstract：

Objective To investigate and analyze the significance of a course of glucocortieosteroids and other drugs for the treatment of patients with sudden deafness present for at least three weeks.Methods A retrospective review was done on 48 patients (58 ears) with sudden deafness present for at least three weeks or more,who were admitted to the Department of Otorhinolaryngology,Peking University People's Hospital from November 2002 to July 2010.The patients were devided into three groups by the type of hearing threshold.The different treatments were used in the three groups.The SPSS 17.0 software was used to analyze the data.Results In patients with a low tone hearing loss (6 ears) ,83.3% improved.For patients with a high tone loss (22 ears) 31.8% improved.For a flat tone hearing loss (30 ears) 36.7% improved.For patients with a hearing loss more than one year (12 ears) there was improvement in 58.3% (7 ears)of the patients.In 9 ears which had a flat tone hearing loss of 90 dB or greater before treatment,77.8% (7 ears) improved with 33.3% (3 ears) having a significant improvement.In 21 ears which had a hearing threshold was under 90 dB,14.3% (3 ears) improved.Conclusions In the treatment of patients with sudden deafness which was longer than 21 days the treatment was significant,especially for those who had a 90 dB or greater flat-tone type hearing threshold before treatment.Even though the hearing loss was more than a year in some patients there was still a benefit from treatment.     

N-acetylcysteine as a single therapy for sudden deafness

Conclusion: Like NAC ameliorates hearing loss from acoustic trauma in the inner ear, NAC may also rescue hearing loss from sudden deafness confined to the inner ear.

Objective: This study assesses the effect of N-acetyl-L-cysteine (NAC) as a single therapy for sudden deafness.

Methods: Thirty-five sudden deafness patients with neither systemic disorders nor central signs in electronystagmography were treated with NAC alone and assigned to Group A. For comparison, another 35 sudden deafness patients treated by corticosteroids and plasma expander were assigned to Group B. There were no significant differences between the two groups in terms of age, sex, laterality, and pre-treatment mean hearing level. All patients underwent an inner ear test battery comprising audiometry, and ocular vestibular-evoked myogenic potential (oVEMP), cervical VEMP (cVEMP), and caloric tests.

Results: Groups A and B did not significantly differ in the pre-treatment mean hearing level, and percentages of abnormal oVEMP, cVEMP, and caloric tests, indicating that the involvement severity of sudden deafness between the two groups was similar. However, Group A (43?±?27?dB) showed significantly greater mean hearing gain than Group B (21?±?28?dB), and Group A (91%) revealed better improved rate of hearing than Group B (57%).     

以听力突然下降为特征的分泌性中耳炎（附24例报告）

目的：提高对以听力突然下降为特征的分泌性中耳炎的确诊率。方法：回顾性分析24例（28耳）以听力突然下降为特征的分泌性中耳炎的临床资料,结果：11例患者被误诊或漏诊,各频率的平均气导阈值在60．2－66．5dBHL,平均骨导阈值在40．5－58．6dBHL,听力图示感音神经性聋9耳,混合性聋19耳,鼓室压图为B型,治疗后听力明显改善,结论,鼓室积液影响圆窗及卵圆窗间的相位差,导致听力突下降,它们的听力图无特征,并对产生误诊的原因进行了讨论。     

Intratympanic steroids as a salvage therapy for severe to profound idiopathic sudden sensorineural hearing loss

Abstract

Background: Idiopathic sudden sensorineural hearing loss (ISSNHL) is defined as a decline in hearing affecting three or more frequencies by 30?dB

Objective: The aim of this study was to evaluate the results of intratympanic steroids as a salvage treatment for severe ISSNHL.

Materials and methods: A regimen of three IT steroid injections was offered to patients who failed a 7-days intravenous steroid treatment. Eighty-four patients underwent IT salvage treatment (IT group). Their outcomes were compared with those of 255 patients with severe ISSNHL who received the same intravenous steroid regimen without salvage IT steroid therapy (Control group).

Results: 56% of the patients in the IT group had a hearing improvement of >15?dB after one month. The average hearing improvements were 26.5?±?28?dB and 27.9?±?24?dB in the IT group and the Control group, respectively (p?=?.67). However, patients with a type E audiogram pattern (total deafness), displayed a substantial hearing gain.

Conclusion: Intratympanic steroids failed to show a global auditory benefit as a salvage treatment in patients with severe ISSNHL.

Significance: Our data suggest that a salvage treatment with intratympanic dexamethasone may be offered to patients with total deafness for whom the first systemic treatment has failed.     

巴曲酶联合常规治疗对不同类型突发性聋患者的疗效观察

目的 观察巴曲酶联合常规治疗在不同听力损失类型的突发性聋患者治疗中的临床疗效.方法 回顾性分析121例(135耳)不同听力损失类型的突发性聋患者的临床资料.按照患者病历资料中是否规范地加用巴曲酶治疗将患者分为常规治疗组69例(79耳)与巴曲酶组52例(56耳),常规治疗组应用激素、营养神经、扩血管药物;巴曲酶组在常规治...     

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.