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[颈源性听力损失]

[Cervicogenic hearing loss].

作者信息

Hülse M

机构信息

Abteilung für Phoniatrie, Pädaudiologie und Neurootologie, Fakultät für Klinische Medizin Mannheim, Universität Heidelberg.

出版信息

HNO. 1994 Oct;42(10):604-13.

PMID:8002367
Abstract

Existing investigations of cervical hearing disorders have been carried out predominantly in patients in whom those with vertebrobasilar insufficiencies (VBI) could not be distinguished from patients suffering from functional deficit of the upper cervical spine. Since two different syndromes exist, no statement can be made about cervical hearing disorders. That deafness can occur in VBI is uncontested. In contrast, there remains a dispute whether a "vertebragenic hearing disorder" exists. This latter disorder is believed accompanied by tinnitus, a feeling of ear pressure, otalgia and deafness as symptoms of a functional deficit of the upper cervical spine. In reviewing the medical findings of 259 patients with well-defined functional deficits of the upper cervical spine and symptoms of cervical vertigo, subjective hearing disorders occurred in 15%. Audiometric threshold shifts of 5-25 dB, most often in lower frequencies, were observed in 40%. Additionally, results of click-evoked otoacoustic emissions (OAE) were negative in spite of approximately normal hearing. Findings in 62 patients suffering from vertebragenic hearing disorders are reported before and after chiropractic management. Results indicate that these hearing disorders are reversible, as demonstrated by audiometry and OAE. The therapy of choice is chiropractic manipulation of the upper cervical spine. The commoness of vertebragenic hearing disorders emphasizes their clinical and forensic importance.

摘要

现有的关于颈性听力障碍的研究主要是在无法区分椎基底动脉供血不足(VBI)患者和上颈椎功能障碍患者的人群中进行的。由于存在两种不同的综合征,因此无法对颈性听力障碍做出任何说明。VBI可导致耳聋这一点是毫无争议的。相比之下,是否存在“脊椎源性听力障碍”仍存在争议。后一种障碍被认为伴有耳鸣、耳压感、耳痛和耳聋,这些是上颈椎功能障碍的症状。在回顾259例明确诊断为上颈椎功能障碍和颈性眩晕症状患者的医学检查结果时,发现15%的患者存在主观听力障碍。40%的患者观察到听力阈值偏移5 - 25 dB,最常出现在低频。此外,尽管听力大致正常,但瞬态诱发耳声发射(OAE)结果为阴性。报告了62例脊椎源性听力障碍患者在整脊治疗前后的情况。结果表明,这些听力障碍是可逆的,这通过听力测定和OAE得到了证实。首选的治疗方法是对上颈椎进行整脊手法治疗。脊椎源性听力障碍的常见性凸显了它们在临床和法医学上的重要性。

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