Department of Otorhinolaryngology, Head and Neck Surgery, Kitasato University, Kanagawa, Japan.
Department of Otorhinolaryngology, Head and Neck Surgery, Kitasato University, Kanagawa, Japan; Department of Otorhinolaryngology, Head and Neck Surgery, National Defense Medical College, Saitama, Japan.
J Int Adv Otol. 2023 Jan;19(1):5-9. doi: 10.5152/iao.2023.22720.
Few investigations have been conducted on the clinical characteristics of the differential diagnosis of acoustic neuroma with acute sensorineural hearing loss and idiopathic sudden sensorineural hearing loss. The aim of the study was to investigate the clinical characteristics of the differential diagnoses between acoustic neuroma and idiopathic sudden sensorineural hearing loss.
The medical records of patients with acute sensorineural hearing loss (142 ears), including acoustic neuroma (19 ears) and idiopathic sudden sensorineural hearing loss (123 ears), who underwent audiometric and hematologic examinations and received systemic corticosteroid treatment, were retrospectively reviewed.
Hematological examination revealed that the erythrocyte sedimentation rate and fibrinogen values were significantly higher in the idiopathic sudden sensorineural hearing loss group compared to the acoustic neuroma group. Although all patients received corticosteroid treatment, hearing thresholds at the initial examination and 3 months after corticosteroid treatment were significantly higher in the idiopathic sudden sensorineural hearing loss group compared to the acoustic neuroma group at all frequencies. However, hearing recovery was worse in the acoustic neuroma group compared to the idiopathic sudden sensorineural hearing loss group. Furthermore, speech discrimination and short increment sensitivity index tests were not significantly different between the acoustic neuroma and idiopathic sudden sensorineural hearing loss groups.
This is the first study to reveal that speech discrimination and short increment sensitivity index tests are not useful for the differential diagnoses between acoustic neuroma and idiopathic sudden sensorineural hearing loss, whereas erythrocyte sedimentation rate and fibrinogen, blood biomarkers of inflammation and blood viscosity, would be considered valuable. Furthermore, acoustic neuroma should be considered in cases where acute sensorineural hearing loss did not recover after corticosteroid treatment, although the initial hearing loss was mild.
鲜有研究针对听神经瘤伴急性感音神经性听力损失与特发性突发性聋的鉴别诊断的临床特征进行调查。本研究旨在探讨听神经瘤与特发性突发性聋鉴别诊断的临床特征。
回顾性分析了接受听力和血液检查并接受全身皮质类固醇治疗的急性感音神经性听力损失患者（142 耳，包括听神经瘤 19 耳和特发性突发性聋 123 耳）的病历。
血液检查显示，特发性突发性聋组的红细胞沉降率和纤维蛋白原值明显高于听神经瘤组。尽管所有患者均接受了皮质类固醇治疗，但特发性突发性聋组在初始检查和皮质类固醇治疗 3 个月后的所有频率的听力阈值均明显高于听神经瘤组。然而，听神经瘤组的听力恢复情况较特发性突发性聋组差。此外，听神经瘤组和特发性突发性聋组之间的言语辨别和短增量敏感指数测试无显著差异。
这是第一项揭示言语辨别和短增量敏感指数测试对于听神经瘤与特发性突发性聋的鉴别诊断没有帮助的研究，而红细胞沉降率和纤维蛋白原等炎症和血液黏度的血液生物标志物则被认为具有价值。此外，虽然初始听力损失较轻，但如果皮质类固醇治疗后急性感音神经性听力损失未恢复，应考虑听神经瘤。
