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声创伤后继发性内淋巴积水

Secondary Endolymphatic Hydrops After Acoustic Trauma.

作者信息

Chen Yi-Jia, Young Yi-Ho

机构信息

*Department of Otolaryngology, Catholic Cardinal Tien Hospital, Fu-Jen Catholic University †Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.

出版信息

Otol Neurotol. 2016 Jun;37(5):428-33. doi: 10.1097/MAO.0000000000001036.

Abstract

OBJECTIVE

This study applied an inner ear test battery in patients with secondary hydrops after acoustic trauma to assess the inner ear deficits.

STUDY DESIGN

Retrospective study.

SETTING

University hospital.

METHODS

Twenty patients with secondary hydrops after acoustic trauma were assigned to Group A. The interval between noise exposure and the testing time varied from 1 month to 3 years (median 3 months). Another 20 patients without progressive hearing loss for at least 3 years after acoustic trauma were assigned to Group B. There were no significant differences between the two groups in terms of age, sex, laterality, and noise source. Before treatment, all patients received audiometry, and caloric, ocular vestibular-evoked myogenic potential (VEMP), and cervical VEMP (cVEMP) tests.

RESULTS

Percentages of abnormal mean hearing level (MHL), cVEMP test, oVEMP test, and caloric test were 75%, 75%, 61%, and 43% in Group A, and 35%, 57%, 61%, and 39% in Group B, respectively. Both groups exhibited a significantly declining sequence in inner ear function. Comparison of the abnormalities in the inner ear test battery between Groups A and B revealed a significant difference in percentages of abnormal MHL, but not in those of abnormal cVEMP, oVEMP, and caloric tests.

CONCLUSION

Secondary hydrops after acoustic trauma occurs mainly on the cochlear part, but less on the vestibular part probably because previous acoustic trauma, i.e., firearms have severely damaged the vestibular partition.

摘要

目的

本研究对声创伤后继发性积水患者应用一套内耳测试组合,以评估内耳功能缺损情况。

研究设计

回顾性研究。

研究地点

大学医院。

方法

将20名声创伤后继发性积水患者归入A组。噪声暴露与测试时间间隔从1个月至3年不等(中位数为3个月)。另外20名声创伤后至少3年无听力进行性减退的患者归入B组。两组在年龄、性别、患侧及噪声源方面无显著差异。治疗前,所有患者均接受了听力测定、冷热试验、眼前庭诱发肌源性电位(VEMP)及颈肌源性电位(cVEMP)测试。

结果

A组平均听力水平(MHL)异常、cVEMP测试异常、oVEMP测试异常及冷热试验异常的百分比分别为75%、75%、61%和43%,B组分别为35%、57%、61%和39%。两组内耳功能均呈显著下降趋势。A组与B组在内耳测试组合异常情况的比较中,MHL异常百分比存在显著差异,但cVEMP、oVEMP及冷热试验异常百分比无显著差异。

结论

声创伤后继发性积水主要发生在耳蜗部分,而在前庭部分较少,这可能是因为既往声创伤,即火器伤已严重损害了前庭分隔。

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