[Acute sensorineural hearing loss in 277 outpatient cases].
[Acute sensorineural hearing loss in 277 outpatient cases].
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门诊急性感音神经性耳聋277例[J].
DOI：
10.3950/jibiinkoka.104.1034
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发表时间：
2001
期刊：
影响因子：
--
通讯作者：
H. Ogawa
中科院分区：
文献类型：
--
作者：
H. Ogawa
受试者为227例急性感音神经性听力损失患者，其中17，146例患者在我们的耳，鼻，喉（E.N.T.）从1994年10月到2000年9月的门诊。其中，45人患有严重和中度特发性突发性听力损失，当0.25，0.5，1，2和4 KHz的听阈算术平均值为40 dB或更差时诊断。在发病后7天内开始药物治疗的30例患者中，18例（60%）显示听力恢复良好或完全恢复，而在发病后8天或较晚开始治疗的15例患者中没有一例显示令人满意的改善。一般来说，越早开始治疗，听力恢复得越好。111例（49%）患者中发现了特发性急性低音感音神经性听力损失，其中女性占优势，M：F比为1：2.3，但在其他疾病中未观察到性别差异。最常见的症状是受影响的耳朵有压力或饱胀感。只有16%的患者意识到他们的听力障碍。约73例（66%）患者完全康复。梅尼埃病被诊断为13，其中听力改善只有2（15%）。9例患者有1次明确的眩晕发作伴低音调感音神经性听力损失，诊断为可能的梅尼埃病，预后良好。7例声损伤性听力损失和1例心因性听力损失预后良好，1例腮腺炎和1例听神经瘤听力未恢复。一位糖尿病肾病患者有低音调听力损失和眼球震颤向受影响的耳朵。利尿剂治疗控制了眩晕发作，但听力恢复略低于10 dB。35例患者有轻度特发性听力损失，预后较好。2例头部损伤后听力障碍，1例擤鼻涕后听力障碍，可能是由于迷路震荡或外淋巴瘘的形成。这种情况的诊断不能通过耳外科手术探查确定。
Subjects were 227 patients with acute sensorineural hearing loss of 17,146 patients seen at our ear, nose, and throat (E.N.T.) outpatient clinic from October 1994 through September 2000. Of these, 45 suffered from profound and moderate idiopathic sudden hearing loss diagnosed when the arithmetical mean of hearing thresholds at 0.25, 0.5, 1, 2, and 4 KHz was 40 dB or worse. Of the 30 patients whose medical treatment was started within 7 days of onset, 18 (60%) showed excellent or complete recovery of hearing, whereas none of the 15 whose treatment was started 8 days or late after onset showed satisfactory improvement. In general, the sooner treatment was started, the better hearing recovered. Idiopathic acute low-tone sensorineural hearing loss was found in 111 (49%) patients with a female preponderance at a M:F ratio of 1:2.3, but no gender difference was seen in other diseases. The most common symptom was a feeling of pressure or fullness in the affected ear. Only 16% of patients were aware of their hearing disturbance. Some 73 (66%) showed complete recovery. Meniere's disease was diagnosed in 13, in whom hearing improved in only 2 (15%). Probable Meniere's disease was diagnosed in 9 patients who had 1 definitive episode of vertigo with low-tone sensorineural hearing loss, and their prognosis was good. The prognosis in 7 patients with hearing loss due to acoustic trauma and 1 with psychogenic hearing loss was good, but normal hearing was not restored in 1 with mumps or 1 with acoustic neurinoma. A patient with diabetic nephropathy had low-tone hearing loss and nystagmus toward the affected ear. Attacks of vertigo were controlled by diuretic therapy, but hearing recovery occurred by a little less than 10 dB. Some 35 patients had mild idiopathic hearing loss and prognosis was relatively good. Hearing was disturbed after head injury in 2 and after nose blowing in 1, probably attributable to concussion of the labyrinth or the formation of a perilymphatic fistula. The diagnosis of this condition could not be made with certainty by surgical exploration of the ear.