Kishimoto Ippei, Yamazaki Hiroshi, Naito Yasushi, Shinohara Shogo, Fujiwara Keizo, Kikuchi Masahiro, Kanazawa Yuji, Tona Risa, Harada Hiroyuki
Department of Otolaryngology, Kobe City Medical Center General Hospital , Kobe.
Acta Otolaryngol. 2014 Jan;134(1):58-65. doi: 10.3109/00016489.2013.831993. Epub 2013 Nov 21.
Rapidly progressive bilateral sensorineural hearing loss (SNHL) often develops as a symptom of intracranial diseases or systemic vasculitis. For early diagnosis and treatment of these potentially fatal diseases, a history of hearing deterioration within 2 months and associated symptoms may be important.
To reveal clinical features and causative diseases for rapidly progressive bilateral SNHL.
The inclusion criterion was patients with bilateral progressive SNHL, who had experienced difficulty in daily conversation within 4 days to 1 year after the onset of hearing loss awareness. This study was a retrospective evaluation of 12 patients with rapidly progressive bilateral SNHL who visited our hospital between 2007 and 2011.
The causative disease for hearing loss was identified in 11 of 12 patients; intracranial lesions including nonbacterial meningitis, meningeal metastasis of lymphoma, and superficial siderosis in 4 patients, systemic vasculitis in 2, auditory neuropathy spectrum disorder in 1, and an isolated inner ear disorder in 4. Relatively rapid hearing deterioration within 2 months showed a significant association in six patients with an intracranial lesion or systemic vasculitis. Moreover, all these six patients complained of dizziness and/or non-cochleovestibular symptoms such as fever, headache, and/or altered mental state in addition to hearing loss.
快速进展性双侧感音神经性听力损失(SNHL)常作为颅内疾病或系统性血管炎的症状出现。对于这些潜在致命疾病的早期诊断和治疗,2个月内听力恶化的病史及相关症状可能很重要。
揭示快速进展性双侧SNHL的临床特征和致病疾病。
纳入标准为双侧进行性SNHL患者,在意识到听力损失发作后的4天至1年内出现日常对话困难。本研究是对2007年至2011年间来我院就诊的12例快速进展性双侧SNHL患者的回顾性评估。
12例患者中有11例确定了听力损失的致病疾病;4例患者为颅内病变,包括非细菌性脑膜炎、淋巴瘤脑膜转移和浅表性铁沉积症,2例为系统性血管炎,1例为听觉神经病谱系障碍,4例为孤立性内耳疾病。2个月内相对快速的听力恶化在6例颅内病变或系统性血管炎患者中显示出显著相关性。此外,这6例患者除听力损失外,均伴有头晕和/或非耳蜗前庭症状,如发热、头痛和/或精神状态改变。