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妊娠期突发性感音神经性听力损失:临床特征、管理及结局

Sudden sensorineural hearing loss during pregnancy: clinical characteristics, management and outcome.

作者信息

Xu Ming, Jiang Qingshan, Tang Hongbo

机构信息

a Department of Otolaryngology-Head and Neck Surgery , The First Affiliated Hospital of University of South China , Hengyang , China.

出版信息

Acta Otolaryngol. 2019 Jan;139(1):38-41. doi: 10.1080/00016489.2018.1535192. Epub 2019 Jan 21.

Abstract

BACKGROUND

Sudden sensorineural hearing loss (SSNHL) may occur during pregnancy with a rare prevalence, and little is known about it.

AIMS

To retrospectively analyze cases of SSNHL during pregnancy and investigate their clinical characteristics, management and outcome.

MATERIAL AND METHODS

Records of 30 SSNHL patients during pregnancy were reviewed, including age, localization, duration from onset to treatment, gestation period, accompanying symptoms, initial hearing threshold, final hearing threshold, audiogram, treatment and outcome.

RESULTS

Twenty-four patients (80.0%) suffered SSNHL in the second trimester or the last trimester with a high rate of tinnitus (70.0%). The initial hearing threshold was 63.4 ± 25.1 dB, and most audiograms were flat and profound. The overall recovery rate was 60.0%, including complete recovery (33.3%) and partial recovery (26.7%). Further, 16 patients received adjuvant intratympanic steroid showed a better audiologic outcome (improvement 27.1 ± 16.4 vs. 15.7 ± 12.0 dB, p = .042) than those who had not.

CONCLUSIONS AND SIGNIFICANCE

SSNHL during pregnancy often occurred in the second trimester or the last trimester with a severe hearing loss, the most audiogram configurations are flat and profound. Dextran-40 is a safe and beneficial therapy for SSNHL patients during pregnancy and adjuvant intratympanic steroid increase the probability of hearing recovery.

摘要

背景

突发性感音神经性听力损失(SSNHL)可能在孕期发生,其患病率很低,人们对它了解甚少。

目的

回顾性分析孕期SSNHL病例,并研究其临床特征、治疗方法及预后。

材料与方法

回顾了30例孕期SSNHL患者的记录,包括年龄、病变部位、从发病到治疗的时长、妊娠期、伴随症状、初始听力阈值、最终听力阈值、听力图、治疗方法及预后。

结果

24例患者(80.0%)在孕中期或孕晚期出现SSNHL,耳鸣发生率较高(70.0%)。初始听力阈值为63.4±25.1dB,大多数听力图为平坦型且重度听力损失。总体恢复率为60.0%,包括完全恢复(33.3%)和部分恢复(26.7%)。此外,16例接受鼓室内注射类固醇辅助治疗的患者,其听力改善情况(改善27.1±16.4dB)优于未接受该治疗的患者(改善15.7±12.0dB,p = 0.042)。

结论与意义

孕期SSNHL常发生于孕中期或孕晚期,听力损失严重,大多数听力图为平坦型且重度听力损失。右旋糖酐40对孕期SSNHL患者是一种安全有效的治疗方法,鼓室内注射类固醇辅助治疗可提高听力恢复的可能性。

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