以突发性耳聋为首发表现的听神经瘤病例临床特征分析  

Clinical Characteristics of Acoustic Neuroma with Sudden Deafness as Its First Manifestation

作　　者：袁婧[1] 董钏[1] 罗刚[1] Yuan Jing;Dong Chuan;Luo Gang(Department of Otolaryngology,Mianyang Central Hospital,Mianyang,Sichuan 621000,China)

机构地区：[1]绵阳市中心医院耳鼻咽喉科,四川绵阳621000

出　　处：《四川医学》2018年第12期1387-1389,共3页Sichuan Medical Journal

摘　　要：目的分析以突发性耳聋为首发表现的听神经瘤病例的发病情况及临床特征。方法回顾性分析2016年1月至2017年9月421例突聋患者的临床资料,探讨其中确诊为听神经瘤的5例患者的临床特征。结果 421例突聋患者中确诊听神经瘤5例,占1. 19%;男5例,年龄32～48岁。其中4例伴有耳鸣,1例伴有眩晕。听力损失轻度2例,重度3例;听力曲线类型呈高频下降型2例,平坦下降型3例。3例ABR异常。管内型3例,中型1例,中大型1例。3例管内型患者采取观察治疗策略,2例手术。结论部分听神经瘤患者的首发临床表现可为突聋,尤其是局限于内听道的小肿瘤。突聋患者应常规行ABR和MRI检查,以免漏诊听神经瘤。根据听神经瘤患者的临床特征选择合适的治疗方案。Objective To analyze the incidence and clinical features of acoustic neuroma with sudden deafness as its first manifestation. Methods The clinical data of 421 patients with sudden deafness from January 2016 to September 2017 were analyzed retrospectively and the clinical features of 5 patients with acoustic neuroma were discussed. Results Among 421 cases of sudden deafness,5 cases(1.19%)were diagnosed as acoustic neuroma;5 males,aged 32 to 48 years.Among them,4 cases were associated with tinnitus and 1 case with vertigo.Hearing loss was mild in 2 cases and severe in 3 cases;The type of hearing curve was high frequency descending type in 2 cases,flat descending type in 3 cases.ABR was abnormal in 3 cases.There were 3 cases of intraductal type,1 case of medium size and 1 case of medium and large size.Three patients with intraductal type were treated by observation and 2 patients were operated. Conclusion The first clinical manifestation of some patients with acoustic neuroma may be sudden deafness,especially small tumors confined to the internal auditory canal.Patients with sudden deafness should be routinely examined by ABR and MRI to avoid missed diagnosis of acoustic neuroma.Appropriate treatment should be selected according to the clinical features of patients with acoustic neuroma.

关 键 词：突发性耳聋 听神经瘤 听觉脑干诱发电位 核磁共振成像 

分 类 号：R764.4[医药卫生—耳鼻咽喉科]