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（auditory brainstem r esponse,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%，阴行者行CT气脑造影或磁共振成像（magnetic resonance imaging,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 place 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.