突发性聋预后影响因素

目的对影响突发性聋的预后因素进行分析讨论。方法回顾分析249例突发性聋患者临床资料,包括年龄、初诊时间,初诊时听力损失程度,听力曲线类型,是否伴有眩晕和耳鸣,进行畸变产物耳声发射(distortion product otoacoustic emissions,DPOAE)检查结果。结果初诊时间为发病后1～23天,患侧耳初诊时250 Hz～4000 Hz平均听力损失40dB以下31例(12.45%),41 dB～70 dB 80例(32.13%);71 dB～90 dB 74例(29.72%),91 dB以上64例(25.70%)。听力曲线上升型72例,下降型81例,平坦型96例。伴有眩晕96例,伴耳鸣174例。治疗药物包括血管扩张剂、皮质类固醇激素、神经营养剂、抗病毒及能量合剂,疗程2～4周。81例进行畸变耳声发射检查,45例在不同频率被引出,经治疗最终被引出DPOAE的频率听力恢复达痊愈水平。结论高龄患者和年龄小的患者预后不良;初诊时间越早听力恢复越好;听力曲线上升型预后好;伴有眩晕者预后不好;能引出DPOAE者听力恢复好。

Preliminary study on prognosis factors of sudden hearing loss

OBJECTIVE To study the prognosis factors of sudden hearing loss.METHODS The clinical data of 249 out-patients of sudden hearing loss in Department of Otolaryngology Head and Neck Surgery of Beijing Tongren Hospital during 2003 to 2006 were retrospectively studied.The clinical data included age, initial diagnosis time,average hearing level of the first pure tone audiometry,type of audiogram,with or without vertigo and distort-product otoacoustic emissions (DPOAE).RESULTS The initial diagnosis time was 1 to 23 days after the onset of the diseases.The degree of hearing loss was evaluated according to the average hearing loss on frequency 250-4000Hz of the affected ear during the first diagnosis.There were 31(<40 dB) cases with light deafness(12.45 %),80(41 to 70 dB) cases with moderate deafness(32.13 %),74(71 to 90 dB)cases with severe deafness(30.71%),and 64 (>90 dB)cases with profound deafness(26.70 %). There were 72 cases with rising audiogram,81 cases with falling audiogram and 96 cases with flat audiogram. There were 96 cases with vertigo and 174 cases with tinnitus.Medicines used included vasodilators,steroid, neural nutritional agents,antiviral agents,energy mixture.Treatment period was 2 to 4 weeks.DPOAE was examined on 81 patients and was presented in 45 patients whose hearing level achieved normal after treatment.CONCLUSION The old and children patients and patients with vertigo have poor prognosis. The earlier the diagnosis,the better the hearing recovered.The rising audiogram and presentation of DPOAE indicate good prognosis.