中华耳科学杂志2012，Vol.10Issue(2)：174-177,4.DOI:10.3969/j.issn.1672-2922.2012.02.008
73例波动性感音神经性聋病因及临床特点分析
Etiologies and clinical characteristics in 73 cases of fluctuating sensorineural hearing loss
摘要
Abstract
Objective To report common etiologies,clinical characteristics and causes of erroneous and missed diagnoses in a series of cases of fluctuating sensorineural hearing loss (FSNHL). Methods The authors retrospectively -analyzed clinical data, audiology and radiology test results of 73 cases with FSNHL. Results ① Etiologies in the 73 cases included: low-tone sensorineural hearing loss (LSNHL, 21/73, 29%), Meniere disease (MD, 17/73, 23%), inner ear malforma-tion(12/73, 16%), delayed endolymphatic hydrops (DEH, 8/73,11%), autoimmune sensorineural hearing loss (ASNHL, 5/ 73, 7%), early stage acoustic neurinoma(4/73, 6%), noise-induced hearing loss(3/73,4%)and unkoown etiologies(3/73, 4%). No auditory neuropathy, perilymph fistula or vascular abnormalities was found in this group of patients. ② Hearing fluctuated only in the low frequency range in LSNHL and early stage MD eases, and only in the high frequency range in early stage acoustic neurinoma and noise-induced hearing loss cases.ASNHL and bilateral inner ear anomalies often showed symmetrical sensorineural hearing loss. ③ Causes of erroneous and missed diagnosis: Symmetrical enlarged vestibule abnormalities could show symmetrical and progressive sensorineural hearing loss attacks in adulthood. Most such cases could be identified by the precipitating factors of attacks, including sudden rises of intracranial or abdominal pressures. Radiology was helpful to differentiate these cases from those of ASNHL; Unilateral high-frequency hearing fluctuation often represented early stage acoustic neurinoma, which could be picked up by enhanced MRI as a routine test to avoid missed diagnosis. Conclusion FSNHLinvolves numerous etiologies. Correct diagnosis depends on not only history, symptomatology and audiology features, but also knowing the precipitating and occupational environment factors.关键词
波动性感音神经性聋/病因/临床特点Key words
Fluctuating sensorineurial hearing loss/ Etiology/ Clinical characteristics分类
医药卫生引用本文复制引用
曾祥丽,李鹏,李永奇,岑锦添,黎志成,王树芳,张革化..73例波动性感音神经性聋病因及临床特点分析[J].中华耳科学杂志,2012,10(2):174-177,4.基金项目
广东省科技计划项目(2010B060900032)资助 （2010B060900032）
