Idiopathic sudden sensorineural hearing loss: etiopathogenic aspects
Idiopathic sudden sensorineural hearing loss: etiopathogenic aspects
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DOI：
10.1590/s0034-72992006000400019
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发表时间：
2006-08-01
期刊：
影响因子：
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通讯作者：
Camargo, Ana Cristina Kfouri
中科院分区：
文献类型：
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作者：
Lazarini, Paulo Roberto;Camargo, Ana Cristina Kfouri
几个因素已被假定为引起特发性突发感音神经性听力损失的病因。通过文献回顾，我们对其临床表现的不同病因方面进行了批判性分析。关于突发性听力损失的可能原因的最新研究表明，血管疾病，内耳膜破裂和自身免疫性疾病;然而，近年来病毒感染受到了极大的关注。对于突发性听力损失的机制知之甚少。病毒可在急性感染中引起突发性听力损失，然而潜伏形式及其可能的再激活也被认为是耳蜗损伤机制的解释。尽管听力损失可以用血液粘度变化来解释，但实验和临床研究并未显示任何骨纤维化和新骨形成或骨膜破裂的证据。这些发现分别与血管和破裂膜因素不一致。针对内耳的抗体的最终存在表明，突发性听力损失的发病机制可能是自身免疫性的，但难以建立其形态学和临床方面与听力损失的相关性也无助于支持这一说法。突发性听力损失在许多方面仍是一个有争议和模糊的话题。
Several factors have been postulated to elicit the etiology of idiopathic sudden sensorineural hearing loss. Through a bibliographic review, we made a critical analysis of the different etiopathogenic aspects of its clinical manifestation. The most recent studies concerning the possible causes of sudden hearing loss suggest vascular disorders, rupture of the inner ear membrane and autoimmune diseases; however, viral infections have received a great deal of attention in recent years. Little is known about the mechanism of sudden hearing loss. Viruses can cause sudden hearing loss in an acute infection, however the latent form, and its possible reactivation have also been considered as explanations of the cochlear injury mechanism. Even though hearing loss can be explained by a blood viscosity change, experimental and clinical studies do not show any evidence of labyrinthine fibrosis and new bone formation, or labyrinthine membrane breaks. These findings are not in agreement with vascular and rupture membrane factors, respectively. The eventual presence of antibodies against the inner ear suggests that sudden hearing loss pathogenesis may be of autoimmune nature, but the difficulty in establishing the correlation of its morphological and clinical aspects to the hearing loss also do not help to support this statement. Sudden hearing loss is still a controversial and obscure subject in several aspects.