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突发性感音神经性听力损失:我们在诊断、治疗及预后方面的经验

Sudden sensorineural hearing loss: our experience in diagnosis, treatment, and outcome.

作者信息

Cadoni Gabriella, Agostino Stefania, Scipione Simona, Ippolito Silvia, Caselli Andrea, Marchese Raffaella, Paludetti Gaetano

机构信息

Iustituteo of Otorhinolaryngology, Catholic University of the Sacred Heart, Rome, Italy.

出版信息

J Otolaryngol. 2005 Dec;34(6):395-401. doi: 10.2310/7070.2005.34606.

Abstract

OBJECTIVES

To describe our experience concerning sudden sensorineural hearing loss (SSNHL) in a large single-institution series of SSNHL patients and to discuss the results.

METHOD

This was a retrospective study, and the charts of 156 consecutive inpatients (65 males, mean age 44 years, range 10-74 years; 91 females, mean age 46 years, range 15-75 years) with the diagnosis of SSNHL from 1987 to 2000 were reviewed. One hundred forty-three of 156 patients received multidrug therapy (plasma expanders, antiaggregants, steroids), whereas only 13 SSNHL patients received hyperbaric oxygen therapy.

RESULTS

Old age, vascular and metabolic risk factors, and cigarette smoking do not a have a high prevalence in the SSNHL population. An etiologic factor was detected in 23 of 156 (15%) cases (16 cases of acute infection, 4 cases of neurovascular conflicts, 2 cases of cerebellar angiomas, 1 case of cochleovestibular schwannoma). The outcome was not related to the laterality, age, or hearing loss type. On the contrary, a statistically significant association between poor recovery and male sex, both tinnitus and vertigo, and the initial severity of the hearing loss was observed.

CONCLUSIONS

Mostly, SSNHL results in idiopathic disease. At present, diagnostic and therapeutic efforts appear to be inadequate to improve the prognosis of SSNHL. Further studies are needed to obtain better knowledge about the etiopathogenesis of SSNHL so that new therapeutic strategies can be considered in the treatment of this challenging ear disease.

摘要

目的

描述我们在一个大型单机构系列突发性感音神经性听力损失(SSNHL)患者中的经验并讨论结果。

方法

这是一项回顾性研究,回顾了1987年至2000年期间156例连续住院的被诊断为SSNHL的患者(65例男性,平均年龄44岁,范围10 - 74岁;91例女性,平均年龄46岁,范围15 - 75岁)的病历。156例患者中有143例接受了多药治疗(血浆扩容剂、抗聚集剂、类固醇),而只有13例SSNHL患者接受了高压氧治疗。

结果

老年、血管和代谢危险因素以及吸烟在SSNHL人群中的患病率不高。156例(15%)病例中有23例检测到病因(16例急性感染、4例神经血管冲突、2例小脑血管瘤、1例耳蜗前庭神经鞘瘤)。结果与患侧、年龄或听力损失类型无关。相反,观察到恢复不佳与男性、耳鸣和眩晕以及听力损失的初始严重程度之间存在统计学上的显著关联。

结论

大多数情况下,SSNHL是特发性疾病。目前,诊断和治疗措施似乎不足以改善SSNHL的预后。需要进一步研究以更好地了解SSNHL的病因发病机制,以便在治疗这种具有挑战性的耳部疾病时考虑新的治疗策略。

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