Sudden deafness: Is it viral?
Sudden deafness: Is it viral?
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DOI：
10.1159/000111048
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发表时间：
2008-01-01
期刊：
影响因子：
--
通讯作者：
Adams, Joe C.
中科院分区：
文献类型：
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作者：
Merchant, Saumil N.;Durand, Marlene L.;Adams, Joe C.
目前对特发性突发性耳聋(ISSHL)的发病机制提出了许多理论，包括病毒感染、血管闭塞、迷路膜断裂、免疫调节机制和耳蜗内异常的细胞应激反应。在本文中，我们对ISSHL的病毒假说进行了批判性的回顾。审查的证据包括已发表的流行病学和血清学研究报告、临床观察和抗病毒治疗结果、形态和组织病理学研究以及动物实验结果。已发表的证据不能满足大多数Henle-Koch关于传染病的病毒病因的假设。回顾了这些假设为何仍未实现的可能解释，并描述了未来可能提供更多洞察力的研究。我们还讨论了解释ISSHL的其他机制。我们的综述表明，血管闭塞、迷路膜破裂和免疫调节机制不太可能是ISSHL的常见原因。最后，我们回顾了我们最近提出的理论，即耳蜗内异常的细胞应激反应可能是ISSHL的原因。版权所有(C)2008 S.Karger AG，巴塞尔。
A number of theories have been proposed to explain the etiopathogenesis of idiopathic sudden sensorineural hearing loss (ISSHL), including viral infection, vascular occlusion, breaks of labyrinthine membranes, immune-mediated mechanisms and abnormal cellular stress responses within the cochlea. In the present paper, we provide a critical review of the viral hypothesis of ISSHL. The evidence reviewed includes published reports of epidemiological and serological studies, clinical observations and results of antiviral therapy, morphological and histopathological studies, as well as results of animal experiments. The published evidence does not satisfy the majority of the Henle-Koch postulates for viral causation of an infectious disease. Possible explanations as to why these postulates remain unfulfilled are reviewed, and future studies that may provide more insight are described. We also discuss other mechanisms that have been postulated to explain ISSHL. Our review indicates that vascular occlusion, labyrinthine membrane breaks and immune-mediated mechanisms are unlikely to be common causes of ISSHL. Finally, we review our recently proposed theory that abnormal cellular stress responses within the cochlea may be responsible for ISSHL. Copyright (c) 2008 S. Karger AG, Basel.