突发性感音神经性听力损失的诊断、鉴别诊断及治疗：中国耳鼻咽喉科的当前诊疗实践
Diagnosis, differential diagnosis, and treatment for sudden sensorineural hearing loss: Current otolaryngology practices in China.
作者信息
Chen Nishan, Karpeta Niki, Ma Xin, Ning Xianhui, Liu Xiaoling, Song Jijun, Jiang Zigang, Ma Xiulan, Liu Xiuli, Zhong Shixun, Sun Qing, Liu Jun, Chen Ganggang, Duan Maoli, Yu Lisheng
机构信息
Department of Otolaryngology, Head, and Neck Surgery, Peking University People's Hospital, Beijing, China.
Department of Otolaryngology, Head, and Neck Surgery, Karolinska University, Solna, Sweden.
出版信息
Front Neurol. 2023 Feb 23;14:1121324. doi: 10.3389/fneur.2023.1121324. eCollection 2023.
INTRODUCTION
Although sudden sensorineural hearing loss (SSNHL) has been attempted to be understood for 70 years, diagnosis and treatment strategies still have strong heterogeneity worldwide, which are reflected in the guidelines issued by countries and the clinical practice of otolaryngologists.
METHODS
Questionnaires were sent to registered otolaryngologists nationwide an online questionnaire system. We investigated the current views and clinical practices of otolaryngologists in mainland China about the diagnosis, examination, and treatment strategies of SSNHL.
RESULTS
Most otolaryngologists supported diagnostic classification audiograms. Regional economic situation and hospital grade affected application strategies for differential diagnosis. Regarding corticosteroid therapy, 54.9% of respondents opted to discontinue the drug 5 days after systemic administration. Both intratympanic therapy and post-auricular injections were selected by more than half of the respondents as initial and salvage treatments.
DISCUSSION
Chinese otolaryngologists exhibit heterogeneity in clinical practices for SSNHL, including distinct approaches to combination therapy and local application of steroids. This study pointed out Chinese doctors' similarities, differences, and unique strategies in diagnosing and treating SSNHL and analyzed the possible reasons to help the world understand the current otolaryngology practices in China.
引言
尽管突发性感音神经性听力损失（SSNHL）已被研究了70年，但全球范围内的诊断和治疗策略仍存在很大差异，这体现在各国发布的指南以及耳鼻喉科医生的临床实践中。
方法
通过在线问卷系统向全国注册的耳鼻喉科医生发送问卷。我们调查了中国大陆耳鼻喉科医生对SSNHL的诊断、检查和治疗策略的当前观点和临床实践。
结果
大多数耳鼻喉科医生支持根据听力图进行诊断分类。地区经济状况和医院级别影响鉴别诊断的应用策略。关于皮质类固醇治疗，54.9%的受访者选择在全身给药5天后停药。超过一半的受访者选择鼓室内注射治疗和耳后注射作为初始治疗和挽救治疗。
讨论
中国耳鼻喉科医生在SSNHL的临床实践中表现出异质性，包括联合治疗和局部应用类固醇的不同方法。本研究指出了中国医生在诊断和治疗SSNHL方面的异同及独特策略，并分析了可能的原因，以帮助世界了解中国目前的耳鼻喉科实践。
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