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[内耳出血所致突发性感音神经性听力损失的临床研究]

[Clinical research of sudden sensorineural hearing loss due to inner-ear hemorrhage].

作者信息

Wu Xuan, Sun Liang, Chen Kaitian, Yang Zhiyun, Chen Xihui, Jiang Hongyan

机构信息

Department of Otorhinolaryngology, the First Affiliated Hospital, Sun Yat-sen University and Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou 510080, China.

Email:

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jul;50(7):540-5.

Abstract

OBJECTIVE

This study addresses the characters of magnetic resonance imaging (MRI) and clinical features, and curative effects in the screening of SSNHL due to inner-ear hemorrhage.

METHODS

MRI and relevant audiometric test were given to 160 patients with SSNHL, who were hospitalized in the First Affiliated Hospital of Sun Yat-sen University from January 2011 to April 2013. The clinical features and curative effects of patients with high signals in the labyrinth on MRI were analyzed.

RESULTS

MRI abnormities were found in 22 (13.8%) of the patients. Specifically, eight cases were considered for inner-ear hemorrhage. For the eight inner-ear hemorrhage cases, clinical features included the sudden onset of complete hearing loss, which worsened within several hours. Pure tone audiometry indicated profound sensorineural deafness. The prevalence of inner-ear hemorrhage was 5% in SSNHL cases and 18.6% in cases of profound sensorineural. MRI showed high signal intensity in the cochlear, semicircular canals or vestibule on unenhanced T1-weighted and fluid-attenuated inversion recovery images. The high signal intensity in the inner ear gradually degraded in six months. There was no improvement in hearing for the patients with inner-ear hemorrhage following symptomatic therapy.

CONCLUSION

SSNHL due to inner-ear hemorrhage is characterized by profound sensorineural deafness in all frequencies, and high signal intensity for the hemorrhagic inner ear on T1-weighted MRI, with poor prognosis.

摘要

目的

本研究探讨内耳出血所致突发性聋(SSNHL)的磁共振成像(MRI)特征、临床特点及疗效。

方法

对2011年1月至2013年4月在中山大学附属第一医院住院的160例SSNHL患者进行MRI及相关听力测试。分析MRI上内耳出现高信号患者的临床特点及疗效。

结果

22例(13.8%)患者存在MRI异常。其中,8例考虑为内耳出血。这8例内耳出血患者的临床特点为听力完全丧失突然发作,数小时内加重。纯音听力测试显示为重度感音神经性聋。内耳出血在SSNHL病例中的患病率为5%,在重度感音神经性聋病例中为18.6%。MRI在未增强T1加权像及液体衰减反转恢复序列图像上显示耳蜗、半规管或前庭高信号。内耳高信号强度在6个月内逐渐降低。内耳出血患者经对症治疗后听力无改善。

结论

内耳出血所致SSNHL表现为各频率重度感音神经性聋,T1加权MRI上出血内耳呈高信号强度,预后较差。

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