Gross Menachem, Wolf Dana G, Elidan Josef, Eliashar Ron
Department of Otolaryngology/Head and Neck Surgery, The Hebrew University School of Medicine, Hadassah Medical Center, Jerusalem, Israel.
Audiol Neurootol. 2007;12(3):179-82. doi: 10.1159/000099021. Epub 2007 Jan 25.
Sudden sensorineural hearing loss (SSNHL) is frequently classified as 'idiopathic' since the causative factor is not identified in most cases. In the present study we determined whether SSNHL is associated with common viral infections, namely enterovirus, cytomegalovirus (CMV) and Epstein-Barr virus (EBV). Between April 2004 and March 2005, we conducted a prospective cohort study on 48 unselected patients with unilateral idiopathic SSNHL. Plasma samples obtained at presentation were analyzed for the presence of enterovirus RNA by reverse-transcription polymerase chain reaction (RT-PCR). Recent occurrence of CMV and EBV infection was determined by serological tests. Among 23 men and 25 women aged 18-84 years (mean age 51.67 years), none presented with clinical symptoms of a viral infection compatible with preceding or concurrent viral infection. One patient (2.08%) had evidence of enterovirus infection by RT-PCR, 3 patients (6.25%) had EBV IgM, and none were positive for CMV IgM. The majority of SSNHL patients (91.67%) did not have evidence of any of the three common viral infections upon presentation. The present study failed to identify recent or concurrent systemic viral infections among SSNHL patients, except for a small proportion who demonstrated recent viral infection. Therefore the theory that viral infection is a factor in SSNHL pathogenesis is not supported by this study. Further studies in larger patient populations and different epidemiological settings are required in order to verify the true role of viral infections in SSNHL.
突发性感音神经性听力损失（SSNHL）常被归类为“特发性”，因为大多数情况下病因不明。在本研究中，我们确定SSNHL是否与常见病毒感染有关，即肠道病毒、巨细胞病毒（CMV）和爱泼斯坦-巴尔病毒（EBV）。在2004年4月至2005年3月期间，我们对48例未经挑选的单侧特发性SSNHL患者进行了一项前瞻性队列研究。通过逆转录聚合酶链反应（RT-PCR）分析就诊时采集的血浆样本中肠道病毒RNA的存在情况。通过血清学检测确定近期CMV和EBV感染的发生情况。在23名男性和25名女性（年龄18 - 84岁，平均年龄51.67岁）中，没有人表现出与先前或同时发生的病毒感染相符的病毒感染临床症状。1例患者（2.08%）经RT-PCR检测有肠道病毒感染证据，3例患者（6.25%）EBV IgM阳性，CMV IgM均为阴性。大多数SSNHL患者（91.67%）就诊时没有这三种常见病毒感染的任何证据。本研究未能在SSNHL患者中发现近期或同时发生的全身性病毒感染，仅有一小部分患者显示近期有病毒感染。因此，本研究不支持病毒感染是SSNHL发病机制中的一个因素这一理论。需要在更大的患者群体和不同的流行病学环境中进行进一步研究，以验证病毒感染在SSNHL中的真正作用。
