大前庭水管综合征临床特征分析(附10例报告)  

Clinical analysis of 10 patients with large vestibular aqueduct syndrome

作　　者：江满杰[1] 王秋萍[2] 崔华[1] 刘应万[1] 王尔贵[1] 罗伟[1] 白亮[1] 

机构地区：[1]第二军医大学南京军医学院附属414医院耳鼻咽喉科,南京210015 [2]南京军区总医院耳鼻咽喉科,南京210003

出　　处：《中华耳科学杂志》2004年第1期15-17,共3页Chinese Journal of Otology

摘　　要：目的分析大前庭水管综合征(largevestibularaquductsyndrome,LVAS)临床特征。方法分析10例(20耳)临床资料,主要分析其诱因、临床表现、听力学检查、CT及MRI资料。结果10例均双侧发病。病前有感冒史1例、头部外伤史1例;重度感音神经性聋9例,有眩晕发作2例;突发性加重聋4例、经治疗后听力恢复到发病前状况2例;1例患者(发病时有眩晕发作,平衡功能检查在治疗后第11天进行)行平衡功能检查,结果为重心动摇图睁眼、闭眼呈中间型,双侧视动反应正常,双侧冰水试验无反应;所有患者DPOAE均未引出;所有患者HRCT显示大前庭水管3郾0-6郾5mm(4郾3±1郾1mm);行颞骨MRI检查1例,T2相前庭水管及内淋巴囊扩大。结论目前LVAS诊断依赖颞骨CT或MRI,保守治疗疗效不明确,早期诊断早期预防是关键。Objective To analyze clinical features of large vestibular aqueduct syndrome ( LVAS). Methods The clinical data of ten patients with LVAS including inducing factor,clinical manifestation,auditory and balance test,CT or MRI of temporal bone were analyzed. Results All cases were suffered from bilateral LVAS. One patients had common cold before onset and one patient's head was struck by a basketball. The onsets of LVAS probably were in childhood,and hearing loss progressed slowly. The profound sensorineural hearing loss was found in nine patients. The sensorineural hearing loss was suddenly deteriorated in four patients, and two of whom recovered to such a degree as before the deterioration after therapy. Two patients had vertigo,one of whom has received balance test after eleven days when vertigo disappeared after treatment. The test showed a intermediate sway pattern during open or closed eyes in posturography, but optokinetic nystagums test was normal and caloric test showed no reaction bilaterally. DPOAE was not induced in all patients. High resolution CT imaging showed that vestibular aqueducts were enlarged with widths from 3.0mm to 6.5mm(4.3±1.1mm), while MRI revealed large vestibular aqueduct in T2W in one case. Conclusion The diagnosis of LVAS depends on the CT scan or MRI. The effect of medicinal treatment is insignificant. The key of hearing preservation is diagnosis and prevention in earily stage.

关 键 词：大前庭水管综合征 LVAS 听力学 平衡功能 感音神经性聋 临床资料 

分 类 号：R764[医药卫生—耳鼻咽喉科]