突发性聋治疗后耳石器功能转归  

Outcome of otolith organ function after treatment of sudden sensorineural hearing loss

作　　者：胡娟[1] 陈耔辰 张玉忠[1] 魏馨雨 赵欢娣 任鹏宇[2] 韩鹏 成颖[1] 史文迪 张青[1] HU Juan;CHEN Zichen;ZHANG Yuzhong;WEI Xinyu;ZHAO Huandi;REN Pengyu;HAN Peng;CHENG Ying;SHI Wendi;ZHANG Qing(Department of Otorhinolaryngology Head and Neck Surgery,the Second Affiliated Hospital of Xi’an Jiaotong University,Xi'an,710004,China;Department of Neurosurgery,the 2nd Affiliated Hospital of Xi’an Jiaotong University;Department of Otorhinolaryngology Head and Neck Surgery,the First Affiliated Hospital of Xi’an Jiaotong University;Clinical Audiology Institute of Hangzhou Ren’ai Deaf Rehabilitation Research Institute)

机构地区：[1]西安交通大学第二附属医院耳鼻咽喉头颈外科,西安710004 [2]西安交通大学第二附属医院神经外科 [3]西安交通大学第一附属医院耳鼻咽喉头颈外科 [4]杭州仁爱耳聋康复研究院临床听力学研究所

出　　处：《临床耳鼻咽喉头颈外科杂志》2020年第11期993-998,共6页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：国家自然科学基金(No:81600809,81670945,81970891);陕西省自然科学基础研究计划(No:2018JQ8001);中央高校基本科研业务费(No:xjj2018279);西安交通大学第二附属医院人才培养专项科研基金[No:RC(GG)201802]。

摘　　要：目的:探讨突发性聋(突聋)治疗后耳石器功能转归情况,以明确突聋患者治疗后内耳病损的恢复情况及预后判断指标。方法:随访24例突聋患者的听力及眼肌前庭诱发肌源性电位(oVEMP)和颈肌前庭诱发肌源性电位(cVEMP)恢复情况。结果:24例患者,治疗前oVEMP无反应5例,cVEMP无反应8例,oVEMP及cVEMP均无反应11例。治疗后共7例患者表现出oVEMP和/或cVEMP波形恢复,其中3例oVEMP恢复反应,1例cVEMP恢复反应,3例oVEMP及cVEMP均恢复反应。根据治疗后VEMP是否恢复分为恢复组和未恢复组,两组间治疗后听力水平及听力改善程度的差异均有统计学意义(P<0.01)。多元Logistic回归分析显示,VEMP恢复是影响突聋预后的独立危险因素。结论:VEMP能够检测部分突聋患者的耳石器功能损伤并动态监测其转归,VEMP恢复是影响突聋预后的独立危险因素,对判断预后及确定治疗周期具有重要意义。Objective:This study aimed to assess the clinical practice value of ocular vestibular evoked myogenic potential(oVEMP)and cervical vestibular evoked myogenic potential(cVEMP)in monitoring the rehabilitation of vestibular function in patients with suddensen sorineural hearing loss(SSHL).Method:Twenty-four patients with SSHL were retrospectively enrolled,showing no VEMP response on the affected side but exhibiting VEMP responses after therapies We analyzed the improvement and the restoration of hearing and the parameters of VEMP response.Result:After treatment,seven patients showed VEMP recovery,including three cases with both oVEMP and cVEMP recovery,three cases with oVEMP recovery,and one case with cVEMP recovery.Between VEMP recoved group and VEMP unrecoved group,before treatment,no significant difference was found in the thresholds of pure-tone audiometry(PTA).However,after treatment,VEMP recoved group exhibited lower PTA thresholds and better PTA shift(P<0.01).Multivariate analysis revealed that recovery of VEMP was the independent risk factor for the therapeutic effect of SSHL.Conclusion:The Combination of oVEMP and cVEMP is an objective tool for assessing vestibular otolithic end organ function during dynamic functional recovery in SSHL and the recovery of VEMP could predict the auditory improvement.

关 键 词：听觉丧失 突发性 眼肌前庭诱发肌源性电位 颈肌前庭诱发肌源性电位 预后 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]