全聋型突发性耳聋患者的预后与前庭症状及前庭功能关系的回顾性分析

Relationship between prognosis and vestibular symptoms/function in patients with unilateral profound sudden sensorineural hearing loss: A retrospective analysis

目的探讨全聋型突发性耳聋患者的预后与前庭症状及前庭功能的关系。方法回顾性分析52例单侧全聋型突发性耳聋患者的前庭症状,以及眼肌前庭诱发肌源性电位(oVEMP)、颈肌前庭诱发肌源性电位(cVEMP)、视频头脉冲试验(vHIT)和冷热试验结果,观察这些患者的听力结果与前庭症状及前庭功能的关系。结果在52例单侧全聋型突发性耳聋患者中,有前庭症状、前庭功能异常的全聋型患者与无前庭症状者、功能正常者相比疗效差异有统计学意义。oVEMP、cVEMP、vHIT和冷热试验四项结果异常的全聋型患者显示出更低的治疗总有效率,oVEMP、cVEMP、vHIT和冷热试验正常的突发性耳聋患者有更高的听力恢复数值。结论有前庭症状、前庭功能异常的全聋型突发性耳聋患者疗效较差,oVEMP、cVEMP、vHIT和冷热试验正常的全聋型突发性耳聋患者有更好的听力恢复。前庭功能异常提示突发性聋患者的内耳病变范围较大、程度较重。

Objective To analyze the relationship between vestibular symptoms and function and hearing outcomes in patients with unilateral profound sudden sensorineural hearing loss(SSNHL).Methods A retrospective analysis of 52 patients with unilateral profound SSNHL was performed.Vestibular symptoms and the results of ocular vestibular evoked myogenic potential(oVEMP),cervical vestibular evoked myogenic potential(cVEMP),video head impulse test(vHIT),and caloric test were analyzed to observe the relationship between hearing outcomes and vestibular symptoms and function.Results Of 52 patients with unilateral profound SSNHL,there was a significant difference between the patients with and without vestibular symptoms,patients with vestibular dysfunction,and those with normal vestibular function.Patients with abnormal oVEMP,cVEMP,vHIT,and caloric test results showed a lower total effective rate.In contrast,patients with normal results in all four tests had a higher hearing recovery.Conclusion Patients with unilateral profound SSNHL with abnormal vestibular dysfunction and symptoms had a poor curative effect.Conversely,those with normal oVEMP,cVEMP,vHIT,and caloric test results had better chances of hearing recovery.Abnormal vestibular function suggests more extensive and severe inner ear lesions in patients with unilateral profound SSNHL.