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可治疗的感音神经性听力损失

Treatable sensorineural hearing loss.

作者信息

Rybak L P

出版信息

Am J Otol. 1985 Nov;6(6):482-9.

PMID:3878093
Abstract

Sensorineural hearing loss is generally felt to be an untreatable medical condition. However, in some cases, prompt diagnosis and treatment of the underlying condition may reverse the deafness. This article summarizes various treatable forms of sensorineural hearing loss and provides illustrative cases histories of patients who have had sensorineural hearing losses that were improved by medical or surgical intervention. Patients with reversible sensorineural deafness due to inadvertent aminoglycoside over-dosage, congenital cholesteatoma, Meniere's syndrome, blood coagulopathy, and perilymphatic fistula all had improvements in auditory function after medical or surgical intervention. Recent experimental studies on animals may explain the basic mechanisms behind hearing loss and recovery. Aminoglycoside ototoxicity appears to have an initial reversible step, followed by a permanent process. Early endolymphatic hydrops and fistulas may cause mechanical effects in the cochlea which can be corrected. Coagulopathy may cause hypoxia which reverses after anticoagulation. These observations reveal that animal experiments can be useful in explaining human auditory dysfunction of the reversible type.

摘要

感音神经性听力损失通常被认为是一种无法治疗的病症。然而,在某些情况下,对潜在病症的及时诊断和治疗可能会使耳聋得到逆转。本文总结了感音神经性听力损失的各种可治疗形式,并提供了一些患者的病例史示例,这些患者的感音神经性听力损失通过药物或手术干预得到了改善。因无意的氨基糖苷类药物过量、先天性胆脂瘤、梅尼埃综合征、血液凝固障碍和外淋巴瘘导致的可逆性感音神经性耳聋患者,在药物或手术干预后听觉功能均有改善。最近对动物的实验研究可能解释了听力损失和恢复背后的基本机制。氨基糖苷类药物的耳毒性似乎有一个初始的可逆阶段,随后是一个永久性过程。早期内淋巴积水和瘘管可能会在耳蜗中产生机械效应,而这种效应是可以纠正的。血液凝固障碍可能会导致缺氧,抗凝后缺氧情况会逆转。这些观察结果表明,动物实验有助于解释人类可逆性听觉功能障碍。

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