突发性聋患者的平衡障碍特征分析  

Characterizing Balance Disorders in Patients with Sudden Sensorineural Hearing Loss

作　　者：刘鹏[1] 潘佳欣 邱泽恒[1] 唐小武[1] 陈玲[1] 冯天赐 郑亿庆[1] 区永康[1] LIU Peng;PAN Jiaxin;QIU Zeheng;TANG Xiaowu;CHEN Ling;FENG Tianci;ZHENG Yiqing;OU Yongkang(Department of Otolaryngology-HNS,Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University,107 Yanjiang west Rd,Guangzhou,510120,China;Department of Otolaryngology-HNS,Foshan Women and Children’s Hospital,11 Renmin Rd,Foshan,528000,China)

机构地区：[1]广州市中山大学孙逸仙纪念医院,广州510120 [2]佛山市妇幼保健院,佛山528000

出　　处：《中华耳科学杂志》2023年第3期292-296,共5页Chinese Journal of Otology

摘　　要：目的 分析突发性聋患者平衡障碍的损伤特征。方法 本研究收集自2016年6月至2020年6月中山大学孙逸仙纪念医院收治并确诊单侧急性以及亚急性突发性聋患者105名。对患者行纯音听阈测试、冷热试验、前庭诱发肌源性电位以评估患者听力-前庭功能,通过感觉整合测试(SOT)评估其平衡功能。结果 1)本研究105名患者中,轻度听力损失17例,前庭功能损伤(23.53%,4/17);中度听力损失18例,前庭功能损伤(38.39%,7/18);重度听力损失28例,前庭功能损伤(64.29%,18/28);极重度听力损失42例,前庭功能损伤(66.67%,28/42)。2)105名突发性聋患者的SOT结果显示,极重度听力损失患者VES_LAT异常率显著高于其他患者组(c2=12.09,P=0.002)。3)93名突发性聋患者的患侧耳PTA与主观DHI评分具有显著的线性相关(P<0.001, r=0.71)。结论 突发性聋会导致患者眩晕及平衡障碍,极重度听力损失患者冠状方向的稳定性显著低于其他听力损失患者。患者的主观眩晕程度与听力损失的程度具有显著的相关性。Objective To characterize balance disorders in patients with unilateral sudden sensorineural hearing loss(SSHL).Methods Patients with unilateral acute or subacute SSHL(n=105)admitted to Sun Yat-Sen University Memorial Hospital from June 2016 to June 2020 were enrolled in this study.Pure tone audiometry,caloric test and vestibular evoked myogenic potentials(VEMPs)were used to evaluate audio-vestibular functions.The sensory organization test(SOT)and DHI scale were used to evaluate balance function.Results Vestibular hypofunction was identified in 4 of the 17 patients with mild hearing impairment(23.53%),in 7 of the 18 patients with moderate hearing impairment(38.39%),in 18 of the 28 patients with severe hearing impairment(64.29%)and in 28 of the 42 patients with profound severe hearing impairment(66.67%).The rate of abnormal VES_LAT was significantly higher in patients with profound hearing loss than in other patients(c2=12.09,P=0.002).DHI scores in 93 patients were also correlated with the severity of hearing loss(P<0.001,r=0.71).Conclusion Balance disorders are not uncommon in patients with unilateral SSHL in the acute and sub-acute stage.Lateral directional stability is more likely affected in patients with severe hearing loss than in other patients.Subjective dizziness is also correlated with severity of hearing loss.

关 键 词：前庭疾病 姿势平衡 感觉整合 

分 类 号：R764[医药卫生—耳鼻咽喉科]