高原地区伴良性阵发性位置性眩晕的突发性耳聋的临床特点

目的 分析高原地区突发性耳聋伴良性阵发性位置性眩晕(BPPV)的临床特点.方法 选取2013年1月至2015年12月兰州军区兰州总医院耳鼻咽喉科收治的148例居住海拔>3000米突发性耳聋患者为观察对象,所有患者均进行变位试验及眼震电图检查,根据检查结果 分为突发性耳聋伴BPPV组45例(BPPV组)和突发性耳聋不伴BPPV组103例(不伴BPPV组);根据听力曲线再将2组分为4型:低中频下降型(Ⅰ型)、中高频下降型(Ⅱ型)、平坦型(Ⅲ型)、全聋型(Ⅳ型).全部患者均进行常规治疗+高压氧治疗,伴BPPV患者按照BPPV类型进行了相应的手法复位治疗,并随访3~12个月.结果BPPV组中高频下降型患者较多(48.89%),不伴BPPV组中平坦型患者较多(43.69%),BPPV组治疗后听力的听阈降低值(16.74±3.72)dB]低于不伴BPPV组(25.59±3.46)dB],BPPV组总有效率(35.56%)低于不伴BPPV组(54.37%),差异有统计学意义(P<0.05).BPPV经手法复位后均治愈.结论 高原地区突发性耳聋伴BPPV治疗后听力改善不明显,疗效较差,耳石复位是治疗BPPV的有效方法.

Clinical characteristics of sudden sensorineural hearing loss with benign paroxysmal positional vertigo in plateau area

Objective To analyze clinical characteristics and recent curative effect of patients with sudden sensorineural hearing loss and benign paroxysmal positional vertigo (BPPV) in plateau area. Methods A total of 148 sudden sensorineural hearing loss patients lived at an elevation of 3000 metres above sea level, who admitted to Department of ENT of Lanzhou General Hospital of Lanzhou Command from January 2013 to December 2015, were selected and divided into two groups according to the results of positioning test and electronystagmography: sudden sensorineural hearing loss with BPPV group (45 cases) and sudden sensorineural hearing loss without BPPV group (103 cases). According to the hearing curve, the two groups could be divided into four types: low intermediate fre-quency (typeⅠ), medium-high frequency (typeⅡ), flat (typeⅢ), total deafness (typeⅣ). All patients received the treatment of routine therapy and hyperbaric oxygen therapy. According to the types of BPPV, patients with BPPV re-ceived manipulative reduction. The data with 3~12 of follow-up of the two groups and treatment effect were analyzed. Results Most patients in BPPV group were high frequency drop type (48.89%), and most patients in non-BPPV group were flat drop (43.69%). The hearing threshold and total effective rate of BPPV group were (16.74 ± 3.72) dB and 35.56%, respectively, which were significantly lower than (25.59±3.46) dB and 54.37%in non-BPPV group (P<0.05). Conclusion The improvement of hearing and treatment effect of patients with sudden sensorineural hearing loss and BPPV are really poor versus those in non-BPPV patients with sudden sensorineural hearing loss. Otolith reset is an effective therapy for BPPV.