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。     

儿童及成人突发性聋预后的对比分析

目的对比分析儿童及成人突发性聋预后的相关因素,为临床实践及患者预后评估提供依据。方法回顾性分析2008年1月~2016年12月住院治疗的237例（258耳）突发性聋患者的临床资料,其中儿童突发性聋患者（儿童组）26例（29耳）,成人突发性聋患者（成人组）211例（229耳）,采用单因素及多因素分析的方法对比分析两组突发性聋患者的年龄、性别、耳侧、初诊时间、就诊听阈、听力曲线、有否伴有耳鸣、眩晕及耳闷等因素对预后的影响。结果儿童突发性聋患者人数占总人数的11.0%;儿童组就诊听阈平均为（88.7±15.8）dB,高于成人组［（71.8±23.6）dB,(P＜0.05)］;儿童组听力曲线为全聋型的占69.0%,高于成人组（44.5%,P＜0.05）;经治疗后,儿童组的总体有效率为51.7%,成人组总体有效率为45.4%,两者差异无统计学意义（P＞0.05）。对儿童组预后的相关因素分析显示就诊听阈及伴发眩晕对疗效的影响具有统计学意义(P＜0.05);成人组中,初诊时间、就诊听阈及伴发眩晕对疗效的影响具有统计学意义（P<0.05）。结论儿童突发性聋患者就诊时听力损失较成人重,但治疗后两者总体有效率无明显差异（P>0.05）;儿童及成人突发性聋患者中听力损失程度越轻且不伴发眩晕者预后较好;就诊时间越早越有利于成人突发性聋患者的预后;而年龄、性别、耳侧以及是否伴发耳鸣、耳闷对儿童及成人突发性聋的预后无明显影响。     

突发性聋预后相关因素分析

目的探讨影响突发性聋(突聋)预后的相关因素。方法收集101例突聋患者的临床资料进行回顾性研究,应用SPSS软件进行单因素分析(χ2检验),统计因素包括性别、年龄、患耳侧别、单双耳、就诊时间、伴发症状、是否伴其他疾病(高血压病、糖尿病、高脂血症)、各频率听力损失值、听力损失程度、听力损失曲线类型、治疗方案等,同时行多因素Logistic逐步回归分析。结果单因素分析结果表明与预后有统计学意义相关性(P<0.05)的因素包括就诊时间、伴眩晕、1000、2000、8000Hz的听力损失值,以及听力曲线类型;多因素分析后发现,就诊时间、伴眩晕以及听力损失曲线类型与预后有相关性(P<0.05)。结论突发性聋患者在发病14天内就诊、听力损失曲线呈上升型预后较佳,伴有眩晕者预后较差。     

影响突发性聋疗效的相关因素分析

目的 探讨影响突聋疗效预后的相关因素.方法 收集本科突聋病例102例(107耳),建立数据库,进行年龄等相关因素的单因素统计分析.结果 突聋的预后与患者年龄、听力曲线、听力损失程度等有统计学意义;其预后与性别、是否伴有耳鸣、是否伴有眩晕及是否1周内就诊无统计学相关性.结论 患者年龄、听力损失程度与突聋预后呈负相关,低频及平坦型的听力曲线预后好于高频或全聋.     

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…     

高压氧辅助治疗突发性聋的疗效评价

目的：探讨高压氧作为辅助治疗对突发性聋疗效的影响。方法：回顾性分析1997～2004年收治的102例采用高压氧（高压氧组）辅助治疗突发性聋患者的临床资料,并将同期除高压氧外其他治疗内容均相同的134例患者作为对照（对照组）,用SPSS软件单因素分析性别、年龄、病程、患耳侧别、是否伴有眩晕或耳鸣、诱因、疗程、既往另耳听力下降病史及耳聋程度对预后的影响,采用多元Logistic回归分析排除影响因素,分析高压氧对疗效的影响。结果：单因素分析：性别、患耳侧别、是否伴有耳鸣、诱因及疗程对听力恢复无影响;年龄、病程、是否伴有眩晕、既往另耳听力下降病史及耳聋程度对听力恢复有影响。Logistic回归分析：高压氧组的治疗有效率（听阈提高15dB以上）与对照组相比明显提高,差异有统计学意义（P〈0．01）。结论：高压氧辅助治疗突发性聋有一定疗效,病程长于14d、伴有眩晕、既往另耳有听力下降病史及极度聋患者的听力恢复相对较差。     

眩晕患者高频测听的初步报告

文中报告23例患者常规测听（0.125-8kHz)和高频测听（9－20kHz)的结果。其中11例为单侧梅尼埃病，12例为耳毒性聋、突聋、供血不足性眩晕、前庭神经元炎等。23例高频听力下降16例（69.1%)。11例梅尼埃病中常规和高频测听听力下降者8例，仅高频听力下降者3例。另外4例耳毒性聋的眩晕、突聋眩晕和供血不足眩晕仅有高频听力改变。高频测听法对早期诊断某些以眩晕症状为主的耳聋患者有帮助。     

突聋患者耳蜗电图与预后的关系

目的：探讨突发性聋（简称突聋）患者耳蜗电图与预后的关系。方法对139例（148耳）突聋患者进行耳蜗电图测试,测得－SP、AP振幅及－SP／AP值,分析引出耳蜗电图耳的不同听阈曲线类型分布,并比较各型听阈曲线耳中－SP／AP≥0．4与－SP／AP＜0．4者的疗效。结果148耳中47耳（10耳全聋,37耳平均听阈为88．93±16．72 dB HL ）未引出耳蜗电图,101耳引出耳蜗电图（平均听阈为57．90±17．91 dB HL ）,其中听阈曲线为低频听力损失型27耳（低频组）,高频听力损失型38耳（高频组）,平坦型听力损失型36耳（平坦组）;低频组中－S P／A P≥0．4者与－SP／AP＜0．4者疗效比较,差异无统计学意义（P＞0．05）,平坦组及高频组中－SP／AP≥0．4者疗效优于－SP／AP＜0．4者（P＜0．05）。结论突聋患者中全聋及极重度聋者耳蜗电图不能引出,低频听力损失型－SP／AP≥0．4者疗效与－SP／AP＜0．4者无统计学差异,平坦型及高频听力损失型－SA／AP≥0．4者疗效优于－SP／AP＜0．4者。     

突发性耳聋预后相关因素的探讨

目的探讨影响突发性耳聋(简称突聋)预后的相关因素，为临床治疗提供帮助。方法收集本院突聋病例68例，建立数据库，进行统计学处理。结果行单因素分析和多因素分析都有统计学意义的因素是年龄，就诊时间，听力损失程度，听力曲线，听力提高的低、中、高频。行多因素分析时族别、眩晕、头痛被剔除。结论患者年龄、就诊时间、听力损失程度与突聋预后呈负相关，中低频的损失与高频损失相比，预后好于高频。多因素逐步分析的方法可使结果更具有准确性和客观性。     

有眩晕及无眩晕突聋的纯音听力表现

本文分析病程２周内的特发性突聋１０９例的有眩晕及无眩晕两组病人的听力损失类型及预后。发现；女性合并眩晕多于男性，有眩晕病人平均年龄高于无眩晕病人。１０９例中深度耳聋型占４１例，平坦听力损失型３１例，高频听力损失型２５例，低频听力损失型９例，中应听力损失碟型３例。１０９例中突聋有眩晕者占４５％。     

Mid-frequency sensorineural hearing loss: aetiology and prognosis

OBJECTIVES: An audiometric finding of mid-frequency sensorineural hearing loss (MFSNHL), or a U-shaped pattern, is uncommon. The objective of this study is to investigate the aetiology and prognostic significance of MFSNHL. DESIGN: Tertiary academic referral centre-based retrospective case review and review of audiograms to determine the prevalence of this audiometric finding. METHODS: Patients with a pure tone threshold average at 1, 2, and 4 kHz at least 10 dB greater than the average at 0.5 and 8 kHz were included in this study; 35 patients met these criteria. The mean age of the patients was 34.6 years old (range 4-71 years). Twelve patients (33 per cent) were under 18 years of age. Serial audiograms were obtained for 14 patients. The notes were reviewed for any pertinent otologic history, subsequent diagnoses, management and disease course. RESULTS: The prevalence of MFSNHL in this practice setting is less than 1 per cent. The average hearing threshold in the mid-frequencies was 44 dB, which was 17 dB and 20 dB lower than at 0.5 Hz and 8 kHz, respectively. The pure tone average (0.5, 1, 2 kHz) was 40 dB. Sixteen patients (44 per cent) required amplification. Of all patients, 22 had hereditary hearing loss, eight had idiopathic hearing loss, and five adults had vestibular schwannomas. CONCLUSIONS: MFSNHL is an infrequent audiometric finding. The great majority of these cases are of presumed hereditary or idiopathic aetiology, although 22 per cent of adults had vestibular schwannomas. This series presents the causes and prognosis of this audiometric pattern.     

Treatment of sudden sensorineural hearing loss: I. A systematic review

OBJECTIVE: To identify, evaluate, and review randomized controlled trials (RCTs) on the treatment of sudden sensorineural hearing loss (SSHL). DATA SOURCES: A MEDLINE search and hand search were conducted to identify RCTs published between January 1966 and February 2006 in the English language on the treatment of SSHL. Search terms included hearing loss, sensorineural (MeSH term), sensorineural hearing loss (text words), and sudden deafness (text words). STUDY SELECTION: Prospective RCTs on the treatment of patients diagnosed as having SSHL. DATA EXTRACTION: One independent observer extracted study data. Validity was evaluated using standard criteria. Characteristics and results were reviewed systematically. DATA SYNTHESIS: A total of 21 RCTs were identified regarding various treatments, including systemic and intratympanic steroids; antiviral and hemodilution agents; mineral, vitamin, and herbal preparations; batroxobin; carbogen; and hyperbaric oxygen. All studies used audiometric outcome measures. Only 2 studies used identical criteria to define SSHL. The method of randomization was described in 2 studies. Validity scores ranged from 2 to 8 (of 9). Positive results were reported favoring systemic steroids, intratympanic steroids, batroxobin, magnesium, vitamin E, and hyperbaric oxygen, although there were serious limitations in each study with a positive finding. There was no difference in audiometric outcomes reported across all studies of antiviral and hemodilution agents and no difference in one study of systemic steroids vs placebo. CONCLUSIONS: To our knowledge, no valid RCT exists to determine effective treatment of SSHL. Systemic steroids cannot be considered the gold standard of treatment of SSHL, given the severe limitations of the landmark study supporting their use.     

低分子右旋糖苷和激素治疗突发性聋的随机对照

目的：探讨低分子右旋糖苷和激素治疗突发性聋（ssHL）的疗效及影响其预后的相关因素。方法：将2002年6月～2003年3月因SSHL住院的100例（105耳）患者,随机分为低分子右旋糖苷治疗组和激素治疗组,并选择11项影响预后的因素进行多因素分析。结果：经Logistic回归分析发现分别有X5（高频听阈平均值）、X6（眩晕）、X9（听力损失程度分型）、X11（治疗方案）共4个变量（均P〈0．05）进入Logistic回归模型。结论：对SSHL患者尽早应用激素治疗不失为一种有效的方法。     

Vertigo as a prognostic sign in sudden sensorineural hearing loss

Several prognostic indicators of favorable outcome in idiopathic sudden sensorineural hearing loss (ISSHL) have been proposed: an initial profound hearing loss, a down-sloping audiometric curve, advanced age, and the presence of vertigo. The latter has been disputed in the literature. The present study addressed the correlation between vertigo and outcome of ISSHL. Sixty-seven patients with ISSHL, aged 52 years on average, were treated with tapered doses of oral prednisone and complete bed rest. Factors found to have a statistically significant prognostic value as indicators of outcome in ISSHL were tinnitus on admission (positive indicator, p < .041) and a descending type of audiometric curve (negative indicator, p < .009). The presence of vertigo was also found to be significantly correlated with the lack of improvement in hearing, but only at the 8-kHz frequency. Dizziness was reported by 27% of the patients. The correlation between the presence of vertigo and persistent high-frequency ISSHL may be explained by the anatomic contiguity of the basal turn of cochlea and the vestibule.     

Vertebrobasilar occlusive disorders presenting as sudden sensorineural hearing loss

BACKGROUND: Isolated sudden sensorineural hearing loss (SSHL) has been rarely related to vertebrobasilar occlusive disorders (VBOD). This is an important issue for both neurologists and otolaryngologists, since the management and prognosis of this type of hearing loss widely differs from that of hearing loss from other causes. OBJECTIVES: To describe the clinical characteristics and report the incidence of SSHL related to VBOD. METHODS: Retrospective analysis of clinical charts from 333 patients admitted for SSHL in a large ear, nose, and throat emergency tertiary care center from 1999 to 2002. RESULTS: Four cases (1.2%) of VBOD as the unique cause of SSHL were diagnosed among 333 patients. The most typical features of these cases were the presence of one of the following characteristics: (1) bilateral SSHL, (2) associated occipital or posterior nuchal pain, and (3) the occurrence of delayed neurologic deficits. The underlying vascular disease affected the vertebral arteries: dissection in two cases and atherosclerosis in two other cases. The audiometric features of hearing loss were endocochlear in one case, of both types in one case, and unknown in two cases. Hearing recovered partially or completely. CONCLUSIONS: Our results confirm the low incidence of SSHL related to VBOD and show that the observation of endocochlear audiometric features cannot preclude a central cause in SSHL. The clinical presentation of our cases related to VBOD emphasize that a careful follow-up of any patient with SSHL is warranted and that the presence of nuchal pain suggestive of arterial dissection in younger subjects, a past history of atherosclerosis or embolism in older patients, or the occurrence of delayed associated neurologic symptoms should be considered with particular caution in this situation.     

全聋型和重度平坦型突发性聋的治疗及预后

目的了解全聋型和严重平坦型突发性聋的治疗效果及影响预后的因素。方法对2003年1月至2006年10月就诊的62例听力损失为中重度以上（0．25、0．5、1、2、4kHz的平均纯音听阈≥56dB）的突发性聋患者进行研究。其中18例单独应用血栓通（三七总皂苷）治疗，19例应用泼尼松加血栓通治疗，25例应用甲泼尼龙加东菱迪芙加血栓通治疗。结果单独应用血栓通的有效率为22．2％（4／18），显效率为5．6％（1／18），应用泼尼松加血栓通的有效率为57．9％（11／19），显效率为36．8％（7／19），联合应用甲泼尼龙、东菱迪芙、血栓通的有效率为68．0％（17／25），显效率为60．0％（15／25）。经统计学处理，应用皮质类固醇激素加血栓通和或加东菱迪芙治疗中重度以上的平坦型或全聋患者的疗效要明显好于单独应用血栓通（P〈0．05）。全聋患者伴眩晕的比率[88．2％（15／17）]明显高于严重平坦型患者[26．7％（12／45）]，且疗效较差。结论严重平坦型预后较好，以大剂量皮质类固醇激素和东菱迪芙为主的联合治疗的效果较好；全聋型往往伴有眩晕，预后较差。     

Sudden sensorineural hearing loss as a revealing symptom of vestibular schwannoma

CONCLUSIONS: Sudden sensorineural hearing loss (SSHL) is a frequent symptom of vestibular schwannoma (VS), often reveals small VSs and does not exhibit specific features. Therefore, every case of SSHL should be evaluated using systematic MRI to rule out VS in order to improve hearing and preservation facial nerve function. OBJECTIVE: SSHL leads to the discovery of a VS in a small proportion of cases (2%). However, SSHL appears to be a more frequent occurrence in the history of patients with VS (3-23% in the literature), suggesting a large disparity in the evaluation of SSHL. MATERIAL AND METHODS: A total of 139 consecutive unilateral VSs operated on between 2000 and 2002 were reviewed and analyzed regarding the prevalence, clinical and audiological features of SSHL and their relation to the size of the tumor. RESULTS: SSHL was observed in 20% of cases at some point in their VS history. The characteristics of SSHL were: (i) lack of a specific audiometric pattern, except that low-tone loss was rare; and (ii) a high rate of hearing recovery (50%). Tumor size was significantly smaller in SSHL-associated VSs compared to other VSs. In the former cases, 96% involved the internal auditory canal.     

Validity and accuracy of electric response audiometry using the auditory steady-state response: evaluation in an empirical design

The validity and accuracy of the application of the auditory steady-state response (ASSR) to electric response audiometry (ERA) was tested further in a study permitting subjects to be their own controls for hearing loss. Simulated sensorineural hearing loss (SSHL) of complex configuration and varying degrees was effected using filtered masking noise. Thresholds estimated via ASSR-ERA were compared to those measured via conventional pure-tone audiometry. Further, the slow vertex potential N1-P2 was recorded to permit a comparison with an evoked-response test of common content validity and known accuracy. Results in a homogeneous subject sample demonstrated strong interest correlation and agreement within 10 dB at 1000 to 4000 Hz (on average), but not at 500 Hz. The configurations determined by ASSR-ERA followed behavioral audiometric patterns well, except for the mildest degree of SSHL tested. Consequently, limitations of ERA remain, although ASSR-ERA appears to be quite valid overall and promises (justifiably) broad clinical applicability.     

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...