颈静脉球高位与耳鸣及听力障碍的关系分析  

The relationship between high jugular bulb and tinnitus and hearing disorder

作　　者：徐嘉 曾祥丽[2] 

机构地区：[1]东莞市第三人民医院耳鼻咽喉头颈外科,广东东莞5230002 [2]中山大学附属第三医院耳鼻咽喉头颈外科

出　　处：《临床耳鼻咽喉头颈外科杂志》2016年第22期1796-1799,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨颈静脉球高位与耳鸣及听力障碍的关系。方法:选取中有听力障碍的49例患者及50例对照组患者,2组患者均行颞骨薄层CT、纯音测听检查,筛选出有听力障碍者,再行声导抗、耳声发射、ABR检查、耳聋基因筛查及耳鸣问卷调查。结果:99例患者中颈静脉球高位为16例,总发生率为16.16%,颈静脉球高位在听力障碍组有14例,发生率为28.57%,在对照组仅2例,发生率为4%,差异有统计学意义(χ2=11.027,P<0.01),听力曲线类型示中高频下降型8例(57.14%)、低中频下降型4例(28.57%)、平坦下降型2例(14.29%),在14例伴听力障碍的颈静脉球高位患者中同时有不同程度的耳鸣,其中搏动性耳鸣占85.71%,非搏动性耳鸣占14.29%,耳鸣类型多为血管性的搏动性耳鸣;2组在GJB2、SLC26A4、mtDNA12srRNA和GJB3 4个常见耳聋相关基因的9个突变位筛查中均未见阳性突变。结论:颈静脉球高位在听力障碍患者中发生率较高,可能为听力障碍的危险因素,临床上对听力障碍的诊疗需要关注颈静脉球高位的影响。Objective：To investigate the relationship between high jugular bulb and tinnitus and hearing disorder.Method：Forty-nine inpatient patients with hearing disorder were selected as the case group,and 50 cases as the control group,two groups of patients conducted temporal CT,audiogram to find out the patients who had hearing disorder,and then acoustic immittance,DPOAE,ABR,genetic screening for deafness and tinnitus questionnaire were conducted to the patients with hearing disorder.Result：Sixteen cases of these 99 patients had high jugular bulb,the total incidence was 16.16%,14 cases in the case group had high jugular bulb,the incidence was28.57%,only 2cases in the control group,the incidence was 4.00%,there was significant difference（χ2=11.027,P〈0.01）between two groups.For the cases group,8cases（57.14%）had hearing loss in the high frequencies,4cases（28.57%）in the low frequencies,2cases（14.29%）in all frequencies;all of these 14 cases withhigh jugular bulb also had different degrees of tinnitus,12 of which had pulsatile tinnitus（85.71%）,vascular pulsatile tinnitus was most common type,2of which had non pulsatile tinnitus（14.29%）.Four common deafness genes GJB2,SLC26A4,mtDNA12 srRNA and GJB3 9 mutation screening tests showed no positive mutation in both groups.Conclusion：High jugular bulb has higher incidence in patients with hearing disorder,which may be a risk factor for hearing disorder.Attention should be paid to the influence of high jugular bulb in clinical diagnosis and treatment of hearing disorder.

关 键 词：颈静脉球高位 耳鸣 听力障碍 危险因素 

分 类 号：R764[医药卫生—耳鼻咽喉科]