单侧听神经病的临床听力学特征分析  

Audiological characteristics of unilateral auditory neuropathy spectrum disorder

作　　者：卢韦欣 杨海弟 LU Weixin;YANG Haidi(Department of Otolaryngology,Guangzhou Development Zone Hospital,Guangzhou,Guangdong,510730,China;Department of Hearing and Speech Science,Guangzhou,Xinhua College,Guangzhou,Guangdong,510190,China)

机构地区：[1]广州开发区医院耳鼻咽喉科,广东广州510730 [2]广州新华学院听力言语科学系,广东广州510190

出　　处：《中国耳鼻咽喉头颈外科》2021年第6期337-339,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的分析单侧听神经病在单侧感音神经性听力损失中的发病率及其听力学特征。方法回顾性分析2008年6月~2020年6月广州开发区医院耳鼻咽喉科489例单侧感音神经性听力损失患者,统计单侧听神经病在单侧感音神经性听力损失中的发病率,比较单侧听神经病和单侧一般感音神经性听力损失的纯音听阈,分析单侧听神经病的声导抗、畸变产物耳声发射(DPOAE)、听性脑干反应(ABR)、视频眼震电图(video-nystagmography,VNG)、内听道MRI检查。结果489例单侧感音神经性听力损失患者中单侧听神经病16例(3.27%),右侧9例,左侧7例;男6例,女10例;年龄9~32岁,平均21岁;平均病程为2.6年。单侧听神经病纯音听阈多为重度以上听力损失,16例单侧听神经病患耳重度或极重度听力损失12例,中重度平坦型听力损失3例,高频下降型听力损失1例。单侧听神经病患者与单侧一般感音神经性听力损失患者的纯音听阈在125、250、500、1000、2000、4000、8000 Hz频段比较,差异均有统计学意义(P<0.05)。DPOAE双耳均能引出,但患耳对侧声抑制效应消失;ABR结果显示14例患耳100 dB nHL强度刺激下未引出任何波形,2例患耳90 dB nHL强度刺激下仅引出V波;VNG结果显示3例患耳单侧半规管功能减退,2例患耳出现对侧优势偏向;8例行内听道MRI检查中3例患耳听神经缺如。结论单侧听神经病临床并不罕见,与一般单侧感音神经性听力损失纯音听阈相比具有明显差异。临床工作中对单侧感音神经性听力损失要完善全面听力学检查,特别是完善影像学MRI检查,对诊断及鉴别诊断均具有重要意义,尽量避免单侧听神经病漏诊。OBJECTIVE To analyze the audiological characteristics of unilateral auditory neuropathy spectrum disorder in the unilateral sensorineural hearing loss.METHODS The retrospective study included 489 patients with sensorineural who received pure tone audiometry,acoustic immittance assessment,distortion product otoacoustic emission,click-auditory brainstem response,video-nystagmography,magnetic resonance imaging.The pour tone average were analyzed by independent samples T test between unilateral auditory neuropathy disorder and unilateral sensorineural hearing loss.RESULTS The overall diagnosis take rate was 3.27%(16/489).Compared to the unilateral sensorineural hearing loss,the unilateral auditory neuropathy spectrum disorder had significant differences in hearing threshold(P<0.05).CONCLUSION Our study demonstrated that unilateral auditory neuropathy spectrum disorder is common.Further thorough audiological test should be carried out to make a definite diagnosis.

关 键 词：前庭耳蜗神经疾病 诱发电位 听觉 脑干 磁共振成像 耳声发射 自发性 单侧听神经病 畸变产物耳声发射 

分 类 号：R764.4[医药卫生—耳鼻咽喉科]