听神经瘤引起突发性听力减退

为了避免听神经瘤的误诊误治，对１９８６～１９９５年收治听神经瘤１０４例中２３例（２４耳）首发症状表现为突发性听力减退者（占２３％）的病例进行分析。听力学检测：纯音听阈＞７１ｄＢＨＬ者１３耳，占５４．２％；听性脑干反应（ＡＢＲ）检测均有异常；耳蜗电图－ＳＰ／ＡＰ检测９耳中７耳＞０．４，占７７．８％；声反射检测１１耳均消失。眼震电图检测１８例，１７例异常（占９４．４％）。影像学检查ＣＴ阳性率８８．８％，阴性者行ＣＴ气脑造影或磁共振（ＭＲＩ）检查均能确诊。提示对突发性听力减退患者应常规检查ＡＢＲ，若异常应行颞骨ＣＴ，必要时ＭＲＩ影像学检查。

Sudden hearing loss in acoustic neuroma

To avoid misdiagnosis and mistherapy of acoustic neuroma,104 cases of acoustic neuroma treated between 1986 and 1995 were retrospectively reviewed.Among them,23 patients (24 ears,23%) presented with sudden hearing loss as the starting symptoms.The clinical and audiological analysis demonstrated that 54.2% of the ears showed hearing loss over 71 dB HL,and all ears had deteriorated ABRs.-SP/AP was measured in nine ears, seven showed -SP/AP greater than 0.4. Acoustic reflex was negative in all 11 ears tested,and 94.4% of the ears showed abnormal ENG.The rate of positive CT scan was 88.8%. The diagnosis was made with CT pneumo encephalography or MRI in those with negative CT result.It was concluded that for patients with sudden deafness, ABR should be used as a routine test.When ABR was abnormal, CT scan of the internal auditory meatus was needed.