突发性聋伴眩晕的临床特点分析  

Clinical analysis of idiopathic sudden sensorineural hearing loss with vertigo

作　　者：巩楠[1,2] 张晓彤[1] 葛丽荞[2] 徐大道 

机构地区：[1]西安交通大学医学院第二附属医院耳鼻咽喉头颈外科病院,西安710004 [2]西安医学院第一附属医院耳鼻咽喉头颈外科,西安710077

出　　处：《临床耳鼻咽喉头颈外科杂志》2015年第22期1963-1965,1969,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨突发性聋(突聋)伴眩晕患者的临床特点及预后。方法:将271例突聋患者分为突聋不伴眩晕组169例和突聋伴眩晕组102例,其中突聋伴眩晕组中34例伴良性阵发性位置性眩晕(BPPV)。全部患者均进行突聋的常规治疗,伴BPPV患者按照BPPV类型进行了相应的手法复位治疗。对患者的纯音听力测试、疗效等临床资料进行分析,总结突聋伴眩晕患者的临床特点。结果:突聋伴眩晕患者听力曲线以高频型(47%)为主,听力损失程度以重度(41%)和极重度聋(35%)为主。突聋伴眩晕治疗后的听阈降低值低于不伴眩晕组治疗后的听阈降低值,且治疗后听力的痊愈率、显效率及总有效率突聋伴眩晕组明显低于突聋不伴眩晕组。其中突聋伴BPPV患者中,后半规管27例(79.4%),外半规管7例(20.6%)。均为同侧患耳。结论:突聋伴眩晕较不伴眩晕患者听力损失严重,且治疗后听力改善及疗效较差。突聋伴BPPV患者较突聋伴非BPPV眩晕患者眩晕症状改善明显,缓解较快。突发性聋伴BPPV主要发生于后半规管,耳石复位治疗是有效的治疗方法。Objective：To explore the clinical characteristics and prognosis of patients with idiopathic sudden sensorineural hearing loss（ISSHL）with vertigo.Method：By analyzing the clinical data of 271 ISSHL patients,they were divided into without vertigo group（n=169）and vertigo group（n=102）.In vertigo group,34 cases were patients with benign paroxysmal positional vertigo（BPPV）secondary to the ISSHL.All patients received conventional treatment.According to the types of BPPV,patients with secondary BPPV received Epley maneuver or Barbecue roll maneuver.By analyzing the results of the pure tone audiometry test and treatment outcomes of the patients,we summarized the clinical characteristics of ISSHL patients with vertigo.Result：The audiometric curves of ISSHL with vertigo group were mainly at high frequency.The degrees of hearing loss of these patients were severe and profound.After treatment,the improvement of hearing threshold for ISSHL with vertigo group was lower than that for ISSHL without vertigo group.What＇s more,the rate of recovery,success and total effective of audition for ISSHL with vertigo group was also obviously lower than that for ISSHL without vertigo group.Of all the patients with BPPV,27 cases of posterior semicircular canal and 7cases of lateral semicircular canal were identified.All patients with BPPV were diagnosed as the same ears as the ISSHL.Conclusion：ISSHL with vertigo group lost hearing more severely than ISSHL without vertigo group.Also,the improvement of hearing and the effective after treatment were really poor.The symptoms of ISSHL with BPPV group improved and eased significantly than that of ISSHL without BPPV group.The major of BPPV secondary to the ISSHL occurs in the posterior semicircular canal.The canalith repositioning is an effective therapy to the secondary BPPV.

关 键 词：听觉丧失 突发性 眩晕 预后 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]