急性低频感音神经性聋临床发病特征和诊断  

Clinical Symptoms and Diagnosis of Acute Low Frequency Sensorineural Hearing Loss

作　　者：李富德[1] 梁瑞敏[1] 陈晨[1] 

机构地区：[1]天津市第一中心医院耳鼻咽喉科,天津300192

出　　处：《听力学及言语疾病杂志》2008年第4期285-289,共5页Journal of Audiology and Speech Pathology

摘　　要：目的探讨急性低频感音神经性聋（acute low-frequency sensori neural hearingloss，ALHL）的临床发病特征和诊断方法．以期避免误诊，提高诊断率。方法回顾性分析34例（35耳）ALHL的临床表现、听力学检测结果和4～5年的随访情况，总结ALHL的临床发病特征。结果本组34例（35耳）ALHL呈急性发病．年龄21～47岁。男11例（32％）．女23例（68％）。单侧占97．06％（33／34例），双侧占2．94%（1／34例）。28例（29耳）伴低调耳呜、耳部堵闷或胀满感。0．125～1kHz平均听阈为29．92±10．61dBHL．2～8kHz平均听阈为9±3．94dBHL。听性脑干反应（ABR）各波潜伏期及波间期正常。耳蜗电图（ECochG）-SP幅值异常增大占54．28名，SP／AP比值异常增大占65．71％。畸变产物耳声发射（DPOAE）在低频区引出率为24．28％，高频区引出率约为97．71％。随访4～5年．31例（91．18形）于初次发病后至今未再复发。结论ALHL以单侧发病为主，常伴低调耳呜、耳部堵闷及胀满感。该病多见于青年女性。PTT以低频听阈升高为特征。ABR正常，ECochG示SP幅值及-SPAP比值增大。Objective To study the clinical symptoms and diagnostic information of acute low frequency sensorineural hearing loss（ALHL）. Methods Clinical findings of audiometry for the last 4-5 years were analyzed in 3.1 cases（35 ears） ,in relation to the data of ALHL. Results The cases indicated that 97.06% （33/34 cases） had unilateral sensorineural hearing loss of acute onset and only 2.94%（1/34 cases） had a bilateral bearing loss. 28 cases（29 ears） had low frequency tinnitus, sensation of fullness or occlusion. Male patients accounted for 11 cases （32%） while female for 23 cases（68%）. The average pure tone threshold （APTT） from 0. 125 to 1 kHz was 29.92 ±10.61 dB HI., and from 2 to 8 kHz was 9±3.94 dB HI.. The rates of abnormal increases in the negative sum mating potential（-SP） amplitude and -SP action potential（AP） ratio were 54.28% and 65. 71% The response rate of distortion product otoacoustic emissions（DPOAE） at low frequencies was 24.28% and at high frequencies, it was 97.71%.Auditory brainstem response（ABR） was normal. All the cases were followed up for ,1-5 years. 31 cases （91. 18%） showed no evidence of the recurrence of hearing loss. Conclusion ALHI. revealed that it usually have the nature of acute onset, mainly unilateral and accompanied by low frequency tinnitus, sensation of fullness or occlusion. Females are more susceptive to the AI.FHI. and hearing loss is usually low frequency. ABR is normal and ECochG showed abnormal increase in SP and SP/AP ratio, characterized by endolymphatic hydrops.

关 键 词：耳聋 感音神经性 内淋巴积水 听阈 低频 

分 类 号：R764.431[医药卫生—耳鼻咽喉科]