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。

Clinical analyses of sudden sensorineural hearing loss in 14 nasopharyngeal carcinomas following radiotherapy

Objective To investigate the clinical characteristics and effects of sudden sensorineural hearing loss in nasopharyngeal carcinoma (NPC) following radiotherapy. MethodsThe clinical characteristics and effects in 14 NPC patients ( 15 ears) with sudden sensorineural hearing loss following radiotherapy were retrospectively analyzed. Results The sudden sensorineural hearing loss happened more in male subjects than female subjects and more in the left ear than the right ear. Its occurrence time was averagely 6.6 years following radiotherapy. Most of the patients suffered hearing loss prior to the sudden sensorineural hearing loss. The 250, 500, 1000, 2000, 4000 Hz average hearing thresholds: sudden hearing loss ears ( 78.5 ± 24.7 ) dBHL, none-sudden hearing loss ears (57.0 ± 32.4 ) dBHL, among which,73.33％( 11/15 ) for sensorineural hearing loss, 26.67％ (4/15) for mixed hearing loss. 12 cases had complications following radiotherapy. At least one case had posterior circulation barrier. The total effective rate was 26.67％ (4/15) and four cases had relapsed and in vain thereafter. Conclusions In NPC patients who received radiotherapy, it caused more serious sudden sensorineural hearing loss and the treatment effects were poor and hearing loss was susceptible to relapse. The pathogenesis may be related to the radiation caused posterior circulation disorders.