以突发性听力减退为首发症状的听神经瘤临床特点分析

目的分析突发性听力减退为首发症状的听神经瘤的临床特点，以避免对该病的误诊、误治。方法对1983～1997年收治听神经瘤92例中20例（21耳）首发症状为突发性听力减退的病例（占21.7%）进行回顾性分析。结果听力学检测纯音听阈（500Hz、1000Hz、2000Hz听力平均听阈）＞71dBHL者12耳，占57.1%；听性脑干反应（auditorybrainstemresponse,ABR）检测均有异常；声反射检测9例（10耳）均消失。影像学检查CT阳性率为88.89%，阴性者行CT气脑造影或磁共振成像（magneticresonanceimaging,MRI）检查均能确诊。结论对突发性听力减退可疑听神经瘤的患者应常规检查ABR，出现异常者应进行颞骨CT，必要时行MRI检查。

Analysis of the clinical salience for sudden hearing loss in acoustic neuroma

Objective To avoid misdiagnosis and misapplied therapy of acoustic neuroma. Methods 92 cases of acoustic neuroma treated between 1983 and 1997 were retrospectively reviewed. Among them, 20 patients (21 ears, 21.7%) presented with sudden hearing loss as the starting symptoms. The diagnosis was based on audiological and radiologic examinations. Results The clinical and audiological analysis demonstrated that 57.1% of the ears showed hearing loss over 71 dBHL, and all ears had deteriorated ABRs. Acoustic reflex was nonreactive in all 10 ears tested. Positive findings in CT scan were 88.89%. CT pneumoencephalography or MRI provided useful information of diagnosis in those with negative findings of plane CT scan. Conclusion ABR should be used as a routine test for patients with sudden deafness. When ABR was abnormal, CT scan around the internal auditory meatus was needed.