Bakhshaee Mehdi, Sorouri Amirhossein, Shoeibi Ali, Boustani Reza, Golhasani-Keshtan Farideh, Amali Amin, Rajati Mohsen
Sinus and Surgical Endoscopic Research Center.
Laryngoscope. 2015 Apr;125(4):956-60. doi: 10.1002/lary.24982. Epub 2014 Oct 29.
OBJECTIVES/HYPOTHESIS: Human T-lymphotropic virus type 1 (HTLV-1) infection is endemic in the northeast area of Iran. Although various neurological disturbances have been reported in HTLV-1 infection, possible audiovestibular involvement during this infection has not yet been studied.
Case control study.
Sixty-eight cases in three groups including 24 HTLV-1-infected patients with HTLV-1- associated myelopathy/tropical spastic paraparesis (HAM/TSP) (group 1), 23 HTLV-1-infected cases without clinical presentation (group 2), and 21 normal individuals (group 3) entered our study. A complete history of hearing-related disorders and a profile of audiologic tests, including pure-tone audiometry (PTA) with high frequencies, speech reception threshold (SRT), and auditory brainstem response (ABR) were taken.
Subjective audiovestibular complaints of participants showed a significant difference among HAM/TSP patients and the two other groups regarding hearing loss and tinnitus, but not vertigo or aural fullness. Hearing evaluation by SRT and PTA in all frequencies showed a significant difference between HAM/TSP patients (group 1) and the controls (group 3). The difference was also significant between asymptomatic cases (group 2) and the controls only in PTA frequencies above 4 kHz. Auditory brainstem-evoked potential did not show any significant differences among the groups regarding latency of I, III, and V waves and interwave differences.
HTLV-1 infection, particularly in those with a clinical presentation, appears to accompany hearing loss. Based on the results of PTA and ABR tests, this study may suggest a cochlear source of hearing impairment rather than neural problems.
目的/假设:人类嗜T淋巴细胞病毒1型(HTLV-1)感染在伊朗东北部地区呈地方性流行。尽管已有报道称HTLV-1感染会引发各种神经功能障碍,但该感染期间可能的听觉前庭受累情况尚未得到研究。
病例对照研究。
三组共68例受试者进入我们的研究,其中包括24例感染HTLV-1且患有HTLV-1相关脊髓病/热带痉挛性截瘫(HAM/TSP)的患者(第1组)、23例未出现临床表现的HTLV-1感染病例(第2组)以及21名正常个体(第3组)。记录了与听力相关疾病的完整病史,并进行了听力测试,包括高频纯音听力测定(PTA)、言语接受阈(SRT)和听觉脑干反应(ABR)。
参与者的主观听觉前庭症状在HAM/TSP患者与其他两组之间,在听力损失和耳鸣方面存在显著差异,但在眩晕或耳闷方面无显著差异。所有频率下通过SRT和PTA进行的听力评估显示,HAM/TSP患者(第1组)与对照组(第3组)之间存在显著差异。无症状病例(第2组)与对照组之间仅在4kHz以上的PTA频率上存在显著差异。听觉脑干诱发电位在I、III和V波潜伏期及波间差异方面,各组之间未显示出任何显著差异。
HTLV-1感染,尤其是有临床表现的患者,似乎伴有听力损失。基于PTA和ABR测试结果,本研究可能提示听力障碍的来源是耳蜗而非神经问题。