以突发听力下降为首发症状小小听神经瘤临床分析  

Clinical study of neuroma burst hearing loss as the first symptom little listen

作　　者：郭强[1] 李国强[1] 李惊涛[1] 翟海程[1] GUO Qiang;LI Guoqiang;LI Jingtao;ZHAI Haicheng(Hanzhong Central Hospital,Hanzhong 723000,China)

机构地区：[1]汉中市中心医院,陕西汉中723000

出　　处：《中国实用神经疾病杂志》2019年第17期1920-1925,共6页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨以突发听力下降为首发症状小小听神经瘤的临床特点,以期提高临床治疗水平。方法回顾性分析2011-02—2014-02汉中市中心医院治疗的31例以突发听力下降为首发症状小小听神经瘤患者,观察其听力学检查和影像学检查情况。结果听力检查上,纯音测听主要表现为轻中度,占74.19%;在声导抗检查上,镫骨肌声反射阳性发生率35.48%,高刺激ABR阳性发生率83.87%,前庭功能检查正常占67.75%。MRI影像学诊断率100%,其中17例表现为双侧听神经形态不对称,5例骨质破坏,6例周围粘连,4例表现为囊变、肿瘤包膜形成。31例患者听力水平均未恢复至正常或病前水平,9例耳鸣和平衡失调症状缓解,5例听力有所改善,眩晕等不适未出现,远期疗效为逐渐进展性。结论对以突发听力下降为首发症状可疑小小听神经瘤的患者需进行听力检查,必要时进行颞骨CT和MRI检查。Objective To investigate the clinical features of small acoustic neuroma with sudden hearing loss as the first symptom,in order to improve the clinical treatment level.Methods A retrospective analysis of 31 patients with small acoustic neuroma who had sudden hearing loss as the first symptom in the Hanzhong Central Hospital from February 2011 to February 2014 was performed to observe the audiological examination and imaging examination.Results On the hearing test,the pure tone audiometry was mainly mild to moderate,accounting for 74.19%.In the acoustic impedance test,the positive rate of sacral muscle reflex was 35.48%,the high stimulating ABR positive rate was 83.87%,and the vestibular function test Normal accounted for 67.75%.The diagnostic rate of MRI imaging was 100%,of which 17 cases showed bilateral aural neuron asymmetry,5 cases of bone destruction,6 cases of peripheral adhesions,and 4 cases of cystic changes and tumor capsule formation.In 31 patients,the hearing level did not return to normal or pre-disease levels,9 cases of tinnitus and balance disorders were relieved,5 cases of hearing improved,dizziness and other discomfort did not appear,and the long-term effect was progressive.Conclusion Hearing tests are required for patients with suspected small acoustic neuroma with sudden hearing loss as the first symptom,and CT and MRI of the tibia are performed if necessary.

关 键 词：突发听力下降 首发症状 小听神经瘤 听力下降 神经损伤 

分 类 号：R764.4[医药卫生—耳鼻咽喉科]