Wang M M, Han Y C, Chen C F, Lyu Y F, Hou Z Q, Fan Z M, Wang H B
Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial Hospital affiliated to Shandong University, Ji'nan 250021, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Sep 7;51(9):644-649. doi: 10.3760/cma.j.issn.1673-0860.2016.09.002.
To investigate the prognostic factors relevant to acute low-tone sensorineural hearing loss (ALHL). 196 adult ALHL patients, including 82 males and 114 females with mean age of (43.1±14.3)years old were included. All patients received the same therapy and were evaluated the curative effect. To evaluate the impact factors on the prognosis of hearing, inclusive of age, gender, time delay before the first visit, degree of deafness, vestibular function, electrocochleogram, and the serum levels of thyroxines by SPSS 18.0 software. Of those 196 patients with ALHL, 124(63.3%) were recovery, 5(2.6%) were excellent better, 42(21.4%) were better, and 25 (12.8%) were poor, with a total effective rate of 87.2%. Among 15 (12.1%) who recurred the hearing loss, 2 developed into Meniere's disease during the follow-up. The mean age of patients with poor hearing effect was significantly older than that of other patients (<0.05). No relativity was found between gender and hearing curative effect. There existed a statistical difference in total effective rate among subjects with different histories (<0.05). In addition, the recovery rate was significantly different between groups, i. e., the course of disease was less than 14 days, between 14 days and 6 months, and between 6 months and 2 years (<0.05). There was no statistical significance in total effective rate among different degrees of deafness (>0.05). However, in term of the recovery rate, the difference was statistical significance (<0.05). The recovery rate in patients with mild hearing loss was higher than that in middle or heavy hearing loss (both <0.05). Among patients with mild deafness, the recovery rate in patients whose history was less than 3 months was significantly higher than that more than 3 months (<0.05). For moderate deafness patients, the recovery rate in patients whose history was less than 7 days was significantly higher than that more than 1 month (<0.05). There were statistical differences in hearing effect of 130 (66.3%) patients with abnormal vestibular function in comparison to that with normal vestibular function (χ=15.1, <0.05). There were 17(8.7%) patients with abnormal electrocochleogram combined with abnormal vestibular function, and the hearing effects were all poor. There were 45 (23.0%) patients with abnormal thyroxine levels in serum, which was significant higher than that in health adults of 5.9%(χ=7.26, <0.01). There was no significant difference in hearing prognosis between patients with abnormal and normal thyroxine levels (χ=2.51, >0.05). With respect to ALHL, the hearing effect is associated significantly with the history. The severity of hearing loss is negative prognostic factor for hearing recovery. Age, vestibular function, and electrocochleogram might predict hearing recovery. Gender and thyroxine levels couldn't predict the hearing prognosis, although there is a high incidence rate in patients with ALHL.
为探讨与急性低频感音神经性听力损失(ALHL)相关的预后因素。纳入196例成年ALHL患者,其中男性82例,女性114例,平均年龄(43.1±14.3)岁。所有患者均接受相同治疗并评估疗效。采用SPSS 18.0软件评估年龄、性别、首次就诊延迟时间、耳聋程度、前庭功能、耳蜗电图及血清甲状腺素水平等对听力预后的影响因素。196例ALHL患者中,痊愈124例(63.3%),显效5例(2.6%),有效42例(21.4%),无效25例(12.8%),总有效率为87.2%。15例(12.1%)复发患者中,2例在随访期间发展为梅尼埃病。听力效果差的患者平均年龄显著高于其他患者(<0.05)。性别与听力疗效无相关性。不同病史患者的总有效率存在统计学差异(<0.05)。此外,不同病程组间痊愈率差异有统计学意义,即病程小于14天、14天至6个月、6个月至2年组间(<0.05)。不同耳聋程度患者的总有效率无统计学意义(>0.05)。但就痊愈率而言,差异有统计学意义(<0.05)。轻度听力损失患者的痊愈率高于中度或重度听力损失患者(均<0.05)。轻度耳聋患者中,病史小于3个月者的痊愈率显著高于病史大于3个月者(<0.05)。中度耳聋患者中,病史小于7天者的痊愈率显著高于病史大于1个月者(<0.05)。130例(66.3%)前庭功能异常患者的听力效果与前庭功能正常患者相比有统计学差异(χ=15.1,<0.05)。17例(8.7%)耳蜗电图异常合并前庭功能异常患者的听力效果均差。血清甲状腺素水平异常的患者有45例(23.0%),显著高于健康成年人的5.9%(χ=7.26,<0.01)。甲状腺素水平异常与正常患者的听力预后无显著差异(χ=2.51,>0.05)。对于ALHL,听力效果与病史显著相关。听力损失程度是听力恢复的负性预后因素。年龄、前庭功能和耳蜗电图可能预测听力恢复。性别和甲状腺素水平虽在ALHL患者中发生率较高,但不能预测听力预后。