内耳出血所致突发性聋患者临床表现特点分析  

Clinical features of sudden sensorineural hearing loss accompanied with inner ear hemorrhage

作　　者：陈希杭[1] 林昶[1] 方哲明[2] 陈曦[1] 叶胜难[1] 程金妹[1] 张榕[1] 

机构地区：[1]福建医科大学附属第一医院耳鼻咽喉头颈外科,福州350005 [2]福建医科大学附属第一医院影像科,福州350005

出　　处：《中华耳鼻咽喉头颈外科杂志》2015年第12期996-1000,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：福建省医药卫生科技创新项目（2014-CX-24）

摘　　要：目的探讨内耳出血所致突发性聋患者的临床特点、诊断方法及预后情况。方法回顾性分析2010年1月至2014年10月11例考虑为内耳出血所致突发性聋患者的临床资料，包括临床表现、实验室检查、听力学、内耳MRI影像学特征等。结果11例患者中男5例、女6例，年龄23～73岁（中位年龄44岁）；均伴有不同程度的眩晕，持续数分钟至数小时不等，其中9例患者伴有持续性耳鸣；根据听力曲线分型，全聋型9例，平坦下降型2例。11例患者通过三维液体衰减反转恢复（three．dimensionalfluid—attenuatedinversionrecovery，3D—FLAIR）序列MRI检查，均发现内耳不同部位有异常高信号影，同时T1WI亦为高信号，其中l例伴对侧内耳膜迷路积水。常规治疗后7例无效，4例听力改善，其中2例显效，2例有效。结论内耳出血所致突发性聋患者均伴有眩晕，听力损失较重，听力曲线多为全聋型，常规治疗疗效不佳。3D—FLAIRMRI检查有助于内耳出血的诊断。Objective To investigate the clinical features, diagnosis and prognosis of sudden sensorineural heating loss accompanied with inner ear hemorrhage. Methods Eleven cases of sudden sensorineural hearing loss accompanied with inner ear hemorrhage were retrospectively analyzed, including clinical manifestation, hematological and audiological examinations, as well as characteristics of inner ear three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging （3D-FLAIR MRI）. Results Eleven cases of sudden hearing loss with inner ear hemorrhage were accompanied by varying degrees of vertigo, lasting from several minutes to several hours, nine of whom had persistent tinnitus. The audiometry curves of the 11 cases included total deafness or flat descending type. The inner ear 3D-FLAIR MRI studies revealed abnormal high signals at different positions of the inner ear, one case with endolymphatic hydrops. After the treatment, seven cases were invalid, two cases had notable effect, and two cases were effective. Conclusions Abnormal high signals in the inner ear were sensitively detected by 3D- FLAIR MRI sequence, which was applied for the diagnosis of the sudden hearing loss accompanied with inner ear hemorrhage. The effect of conventional treatment was not good and the appropriate treatments for this type of sudden hearing loss need further investigation.

关 键 词：听觉丧失 突发性 内耳 出血 磁共振成像 预后 

分 类 号：R764.437[医药卫生—耳鼻咽喉科]