Gao Yun, Wang Dayong, Su Qin, Wang Hongyang, Lan Lan, Yin Zifang, Yu Lan, Wu Ziming, Shan Xizheng, Xue Xijun, Wang Qiuju
Department of Otolaryngology Head and Neck Surgery, Institute of Otolaryngology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jul;50(7):529-35.
To analyze the clinical characteristics, prognosis and therapeutic effects of sudden sensorineural hearing loss (SSHL) patients associated with vertigo, and to investigate the strategy of diagnosis and treatment.
We retrospectively analyzed the clinical characteristics of 240 patients diagnosed as SSHL with vertigo, who were treated in the Chinese PLA General Hospital from July 2008 to August 2012. Various factors affecting the therapeutic effects were analyzed, such as audiological features, vestibular function tests, genders, audiograms, lasting before seeing a doctor, courses of vertigo and vascular factors.
Among the contemporaneous SSHL patients (873 cases), the cases with vertigo accounted for 27.49% (240/873). Among the 240 patients with vertigo, the cases with different hearing impaired degree of mild, moderate, severe and profound were 30, 13, 28 and 34, respectively, primarily by the profound cases. Detailed vestibular function tests were performed in 97 patients, with 54 cases having unilateral vestibular disfunction and 43 patients having normal vestibular function, among which 23 cases were diagnosed as benign paroxymal positional vertigo (BBPV). The relationship between vestibular function and different hearing impaired degrees or various audiogram types had no statistically significant difference. 219 cases had detailed records of the onset time of cochlear and vestibular symptoms, including 122 patients with cochlear symptoms and dizziness occurring simultaneously. After standardized drug treatment, the total effective rate was 46.67%, with recovery in 17 cases, excellent in 34 cases, better in 61 cases and poor in 128 cases, respectively. Statistical analysis showed that different genders, audiogram types, vertigo courses of time, the results of vestibular function and neck vascular ultrasounds were not related to the curative effects, while, the treatment time after onset was significantly associated with treatment effects.
SSHL with vertigo has a high incidence, primarily single side affected, with relatively severe hearing impairment, and total deafness and downslope hearing curve mainly. Vestibular function can be normal or low in SSHL patients with vertigo, with a higher incidence of BPPV. Vestibular and cochlear symptoms occur simultaneously in more than half of the patients. The detection rate of vestibular dysfunction gradually increased, as the degree of hearing loss increased, without statistical significance although. The therapeutic effects of sudden hearing loss with vertigo cases have no relationship with dizziness duration or vestibular function, while the disease course plays an important role in treatment.
分析伴眩晕的突发性聋(SSHL)患者的临床特征、预后及治疗效果,探讨其诊治策略。
回顾性分析2008年7月至2012年8月在中国人民解放军总医院就诊的240例诊断为SSHL伴眩晕患者的临床特征。分析影响治疗效果的各种因素,如听力学特征、前庭功能检查、性别、听力图、就诊前病程、眩晕病程及血管因素等。
同期SSHL患者873例,其中伴眩晕者占27.49%(240/873)。240例伴眩晕患者中,轻度、中度、重度及极重度听力受损者分别为30例、13例、28例及34例,以极重度病例为主。对97例患者进行了详细的前庭功能检查,其中54例单侧前庭功能障碍,43例前庭功能正常,其中23例诊断为良性阵发性位置性眩晕(BPPV)。前庭功能与不同听力受损程度及不同听力图类型之间的关系无统计学差异。219例有耳蜗和前庭症状发作时间的详细记录,其中122例耳蜗症状和头晕同时出现。经规范化药物治疗后,总有效率为46.67%,分别有17例痊愈,34例显效,61例有效及128例无效。统计学分析显示,不同性别、听力图类型、眩晕病程时间、前庭功能及颈部血管超声结果与疗效无关,而发病后治疗时间与治疗效果显著相关。
伴眩晕的SSHL发病率高,主要为单侧受累,听力损害相对较重,以全聋及下降型听力曲线为主。伴眩晕的SSHL患者前庭功能可正常或降低,BPPV发病率较高。半数以上患者耳蜗和前庭症状同时出现。随着听力损失程度增加,前庭功能障碍检出率逐渐升高,但无统计学意义。伴眩晕的突发性聋患者的治疗效果与头晕持续时间或前庭功能无关,而病程对治疗起重要作用。