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[局部振动所致振动综合征的内耳损害]

[Internal ear damage in vibration syndrome caused by local vibration].

作者信息

Kowalska S, Sułkowski W

机构信息

Z Samodzielnej Pracowni Otolaryngologii i Audiologii Instytutu Medycyny Pracy w Lodzi.

出版信息

Med Pr. 1989;40(3):169-76.

PMID:2593815
Abstract

Unlike with the vibration syndrome caused by general vibration whose clinical picture may exhibit internal ear impairments in the of hearing losses and vestibular disturbances, similar lesions in the vibration syndrome due to local vibration have not been confirmed explicitly. For better explanation of this issue, analysed were the results of audiometric and electronystagmographic (ENG) tests in a group of 40 otologically healthy++ men, in whom during 1986-1987 the angioneurotic vibration syndrome was diagnosed. The results were analysed considering subjects' age and duration of work in exposure; evaluation involved the increase in hearing thresholds for pure tones (audiometer Peters AP-6) and quantitative and qualitative changes in ENG records (electronystamograph Tonnies D-420 TS), calculating, among others, amplitudes and angular velocity of nystagmus slow phase. In 75% of subjects (30 persons) sensorineural hearing losses of different degree were found, mostly within the 3000-8000 Hz range, demonstrating a directly proportional dependence on the length of employment. Symptoms of vestibular disturbances in ENG records were detected in 57.2% (23) persons with marked predominance of the cases of vibration exposure over 10 years. The authors analyse mechanisms of the development of internal ear impairments in result of local vibration and concomitant noise.

摘要

与全身振动引起的振动综合征不同,其临床表现可能包括听力损失和前庭功能障碍等内耳损伤,而局部振动引起的振动综合征中类似病变尚未得到明确证实。为了更好地解释这个问题,对一组40名耳科健康的男性进行了听力测定和眼震电图(ENG)测试结果分析,这些男性在1986 - 1987年期间被诊断出患有血管神经性振动综合征。分析结果时考虑了受试者的年龄和工作暴露时长;评估包括纯音听力阈值的增加(听力计Peters AP - 6)以及ENG记录中的定量和定性变化(眼震电图Tonnies D - 420 TS),其中计算了眼震慢相的幅度和角速度等。在75%的受试者(30人)中发现了不同程度的感音神经性听力损失,大多在3000 - 8000赫兹范围内,且与工作时长呈正比。在57.2%(23人)的受试者中,ENG记录检测到前庭功能障碍症状,其中振动暴露超过10年的病例占明显优势。作者分析了局部振动及伴随噪声导致内耳损伤的发生机制。

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