Fetterman B L, Luxford W M, Saunders J E
House Ear Clinic and House Ear Institute, Los Angeles, Calif. 90059, USA.
Laryngoscope. 1996 Nov;106(11):1347-50. doi: 10.1097/00005537-199611000-00008.
Most cases of sudden sensorineural hearing loss (SHL) remain idiopathic, and the majority are unilateral. From 1989 to 1993, 823 patients with sudden SHL were evaluated. Of these, 14 (1.7%) had sudden bilateral SHL. We reviewed the charts of these 14 patients to compare sudden bilateral SHL with sudden unilateral SHL. Usually, bilateral SHL was asymmetric. Most bilateral cases received combined steroid and vasodilator treatment, while unilateral cases were more likely to receive only one of these treatments. By audiological criteria, 67% of bilateral SHL cases improved, while the improvement rate in unilateral SHL was 52%; however, this difference was not statistically significant. In bilateral SHL patients showing improvement, both ears responded. Bilateral SHL patients were older at the onset of hearing loss, had a higher incidence of vascular disease, and were more likely to have positive antinuclear antibody titer. Recognition of similarities and differences between sudden unilateral and bilateral SHL can help in counseling patients.
大多数突发性感音神经性听力损失（SHL）病例仍病因不明，且大多数为单侧性。1989年至1993年期间，对823例突发性SHL患者进行了评估。其中，14例（1.7%）为突发性双侧SHL。我们回顾了这14例患者的病历，以比较突发性双侧SHL与突发性单侧SHL。通常，双侧SHL是不对称的。大多数双侧病例接受了类固醇和血管扩张剂联合治疗，而单侧病例更有可能仅接受其中一种治疗。根据听力学标准，67%的双侧SHL病例听力有所改善，而单侧SHL的改善率为52%；然而，这种差异无统计学意义。在听力改善的双侧SHL患者中，双耳均有反应。双侧SHL患者听力损失发病时年龄较大，血管疾病发病率较高，抗核抗体滴度呈阳性的可能性也更大。认识到突发性单侧和双侧SHL之间的异同有助于为患者提供咨询。
