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流行性腮腺炎后耳聋:耳聋的可能发病机制及发生率

Deafness following mumps: the possible pathogenesis and incidence of deafness.

作者信息

Mizushima N, Murakami Y

出版信息

Auris Nasus Larynx. 1986;13 Suppl 1:S55-7. doi: 10.1016/s0385-8146(86)80035-9.

Abstract

Mumps is thought to be the most common cause of unilateral acquired sensorineural deafness in children. Mumps deafness is usually sudden in onset, profound or complete, and may be associated with vestibular symptoms. The authors' clinical survey of 55 patients with unilateral deafness which could reasonably be ascribed to mumps indicates that the hearing loss is exclusively unilateral, severe or total and permanent, and that approximately 45% of the patients experienced dysequilibrium of vestibular origin. An analysis of the present series of mumps deafness also suggests that the primary route of invasion of the virus is hematogenous, and thus the term "viral endolymphatic labyrinthitis" is proposed as the possible pathogenesis of the deafness, since both tympanogenic and meningogenic routes of viral invasion to the labyrinth can be excluded on the basis of the clinical and cerebrospinal fluid studies. This view of the pathogenesis, particularly that mumps meningitis is not associated with deafness, is supported by several reports including those of Vuori et al. (1962), Azimi et al., (1969), Lindsay (1973), Nadol (1978), etc. The incidence of deafness following mumps appears to be extremely low, approximately 1:20,000, as estimated by Everberg (1957).

摘要

腮腺炎被认为是儿童单侧获得性感音神经性耳聋最常见的病因。腮腺炎致聋通常起病突然,听力严重下降或完全丧失,且可能伴有前庭症状。作者对55例可合理归因于腮腺炎的单侧耳聋患者进行的临床调查表明,听力损失仅为单侧、严重或完全性且为永久性,约45%的患者出现前庭源性平衡失调。对本系列腮腺炎致聋病例的分析还表明,病毒的主要侵入途径是血行性的,因此提出“病毒性内淋巴迷路炎”作为耳聋可能的发病机制,因为根据临床和脑脊液研究可排除病毒经鼓室和经脑膜侵入迷路的途径。包括Vuori等人(1962年)、Azimi等人(1969年)、Lindsay(1973年)、Nadol(1978年)等的几份报告支持了这种发病机制的观点,特别是腮腺炎脑膜炎与耳聋无关的观点。据Everberg(1957年)估计,腮腺炎后耳聋的发病率似乎极低,约为1:20000。

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