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[特发性突发性感音神经性听力损失中血迷路屏障的变化及其与临床特征和预后的关系]

[The changes of blood-labyrinth barrier in idiopathic sudden sensorineural hearing loss and the relationship with clinical features and prognosis].

作者信息

Wang M M, Sun X, Hu N, Hou Z Q, Xiong W P, Wang Y J, Fan Z M, Wang H B

机构信息

Department of Otological Medicine, Shandong Provincial ENT Hospital, Shandong University, Jinan 250022, China.

Medical Imaging Center, Shandong Provincial ENT Hospital, Shandong University, Jinan 250022, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Aug 7;57(8):937-942. doi: 10.3760/cma.j.cn115330-20210705-00429.

Abstract

To investigate the clinical features and prognosis in patients with idiopathic sudden sensorineural hearing loss (ISSNHL) with blood-labyrinth barrier breakdown (BLB-B). Clinical data of patients with unilateral ISSNHL hospitalized from December 2017 to December 2018 were retrospectively analyzed. According to the results of 3D-FLAIR MRI and enhanced MRI scanning, these patients were divided into two groups, i.e., normal and abnormal inner ear groups. The patients in abnormal inner ear group were further divided into two subgroups: BLB-B and BLB-B with exudation. The differences and correlations among the groups in clinical characteristics, in terms of gender, age, deafness side, basic diseases, dizziness/vertigo, vestibular function, hearing loss degree, as well as classification of hearing curve, and prognosis were analyzed by statistical software SPSS 23.0. Data were collected from 150 cases, in which 68 were male and 82 were female, aged (46.2±14.6) years, including 67 cases with normal inner ears and 83 cases with abnormal inner ears (13 cases with BLB-B; 70 cases with BLB-B and exudation). The dizziness/vertigo incidence, side ratio, hearing loss degree, classification of hearing curve, vestibular dysfunction (vestibular double temperature test, HIT and VAT) and therapeutic effect were different between normal and abnormal inner ear groups (<0.05). The dizziness/vertigo incidence, side ratio, hearing loss degree, classification of hearing curve, vestibular dysfunction (vestibular double temperature test, o/cVEMP, HIT and VAT) and therapeutic effect were different among normal inner ear, BLB-B and BLB-B with exudation groups (<0.05). Pairwise comparison between groups revealed that vestibular dysfunction (vestibular double temperature test, o/cVEMP, HIT and VAT) and therapeutic effect were different between normal inner ear and BLB-B groups (<0.05); The dizziness/vertigo incidence, side ratio, hearing loss degree, classification of hearing curve, vestibular dysfunction (vestibular double temperature test, o/cVEMP, HIT and VAT) and therapeutic effect were different between normal inner ear and BLB-B with exudation groups (<0.05). There was no significant different between BLB-B and BLB-B with exudation groups. BLB-B displayed by 3D-FLAIR MRI manifestation in ISSNHL patients indicates more serious cochlear and vestibular dysfunction, and worse therapeutic effect.

摘要

探讨血迷路屏障破坏(BLB - B)的特发性突发性感音神经性听力损失(ISSNHL)患者的临床特征及预后。回顾性分析2017年12月至2018年12月住院的单侧ISSNHL患者的临床资料。根据三维液体衰减反转恢复序列(3D - FLAIR)磁共振成像(MRI)及增强MRI扫描结果,将这些患者分为内耳正常组和内耳异常组。内耳异常组患者进一步分为两个亚组:血迷路屏障破坏组和血迷路屏障破坏伴渗出组。采用统计软件SPSS 23.0分析各组在性别、年龄、耳聋侧别、基础疾病、头晕/眩晕、前庭功能、听力损失程度、听力曲线分类等临床特征方面的差异及相关性,以及预后情况。共收集150例患者的数据,其中男性68例,女性82例,年龄(46.2±14.6)岁,包括内耳正常67例,内耳异常83例(血迷路屏障破坏13例;血迷路屏障破坏伴渗出70例)。内耳正常组与内耳异常组在头晕/眩晕发生率、侧别比例、听力损失程度、听力曲线分类、前庭功能障碍(前庭双温试验、冷热试验和视频眼震图)及治疗效果方面存在差异(P<0.05)。内耳正常组、血迷路屏障破坏组和血迷路屏障破坏伴渗出组在头晕/眩晕发生率、侧别比例、听力损失程度、听力曲线分类、前庭功能障碍(前庭双温试验、颈肌前庭诱发肌源性电位、冷热试验和视频眼震图)及治疗效果方面存在差异(P<0.05)。组间两两比较显示,内耳正常组与血迷路屏障破坏组在前庭功能障碍(前庭双温试验、颈肌前庭诱发肌源性电位、冷热试验和视频眼震图)及治疗效果方面存在差异(P<0.05);内耳正常组与血迷路屏障破坏伴渗出组在头晕/眩晕发生率、侧别比例、听力损失程度、听力曲线分类、前庭功能障碍(前庭双温试验、颈肌前庭诱发肌源性电位、冷热试验和视频眼震图)及治疗效果方面存在差异(P<0.05)。血迷路屏障破坏组与血迷路屏障破坏伴渗出组之间无显著差异。3D - FLAIR MRI显示的ISSNHL患者血迷路屏障破坏提示耳蜗及前庭功能障碍更严重,治疗效果更差。

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