鼻咽癌放疗后突发性聋18例

目的 探讨鼻咽癌放疗后突发性聋(突聋)的临床特征及预后,为该类疾病的临床诊治提供依据。 方法 收集并分析18例鼻咽癌放疗后突聋患者的临床资料,包括年龄、性别、耳侧、病程、伴随症状、听力曲线类型、听力损失程度、放疗后突聋发病间隔以及听力预后。 结果 18例均为单侧发病,左侧10耳(55.56%),右侧8耳(44.44%);其中男15例(83.33%),女3例(16.67%);11耳(61.11%)伴有耳鸣,10耳(55.56%)伴有眩晕;10例(55.56%)表现为全聋型,12例(66.67%)听力损失为重度或极重度。患者治疗结束、治疗1个月和3个月后,痊愈率、显效率、有效率和无效率分别为5.56%、11.11%、16.67%、66.67%,5.56%、16.67%、16.67%、61.11%和5.56%、11.11%、22.22%、61.11%,三个时间点的疗效指标差异无统计学意义(P>0.05);患耳平均听阈改善值和对侧耳平均听阈改善值分别为(12.22±5.16)dB HL、(3.61±2.33)dB HL,(13.89±6.88)dB HL、(4.44±2.15)dB HL,(13.33±6.02)dB HL、(3.89±2.58)dB HL,组间比较差异有统计学意义(P<0.05)。 结论 鼻咽癌放疗后突聋患者听力损失较重且眩晕伴发率较高,听力曲线以全聋型为主;该类患者听力预后较差,但积极治疗后仍可改善听力预后,甚至痊愈。

Clinical characteristics and prognosis of sudden sensorineural hearing loss in post-irradiated nasopharyngeal carcinoma survivors:a report of 18 cases

Objective The aim of this study is to analyze the clinical characteristics and prognosis of sudden sensorineural hearing loss(SSNHL)in post-irradiated nasopharyngeal carcinoma(NPC)survivors.Methods Medical records of 18 SSNHL patients diagnosed with NPC(NPC group)between January 2014 and May 2019 were reviewed and analyzed,including age,sex,side,treatment delay time,accompanying symptoms,hearing loss severity,audiogram pattern,interval between SSNHL and NPC,and post-treatment hearing outcome.Results Eighteen patients had unilateral hearing loss,including 10 right ears(55.56%)and 8 left ears(44.44%);the sex distribution comprised of 15 males(83.33%)and 3 females(16.67%);11 ears(61.11%)were accompanied with tinnitus and 10 ears(55.56%)were accompanied with vertigo;10 patients(55.56%)exhibited total deafness-type hearing loss,and 12 patients(66.67%)suffered severe or profound hearing loss.The rates of complete recovery,significant recovery,partial recovery,and no recovery after treatment,1 month post-treatment,and 3 months post-treatment were 5.56%,11.11%,16.67%,66.67%,5.56%,16.67%,16.67%,61.11%,and 5.56%,11.11%,22.22%,and 61.11%,respectively.No statistical difference was observed between the three groups(P>0.05).Hearing gains and contralateral hearing gains were 12.22±5.16 dB HL,3.61±2.33 dB HL,13.89±6.88 dB HL,4.44±2.15 dB HL,13.33±6.02 dB HL,and 3.89±2.58 dB HL,respectively,and hearing gains were higher than the contralateral hearing gains(P<0.05).Conclusion In this study,post-irradiated NPC survivors with SSNHL demonstrated a severe hearing loss with a high rate of accompanying vertigo,and most audiograms revealed total deafness.Although hearing recovery is poor,active treatment can still improve the hearing prognosis and can even be curative.