儿童波动性听力下降及眩晕与大前庭导水管综合征

Fluctuate hearing loss with vertigo in childhood and the large vestibular aqueduct syndrome

由于儿童对眩晕叙述不清，临床症状常不典型，辅助检查不易实施，故诊断比较困难，尤其在以波动性听力下降和眩晕为主诉时，更易误诊。作者对７例反复发作眩晕伴听力下降和耳鸣的患儿进行详细检查发现，其颞骨ＣＴ均显示出前庭导水管扩大，说明该征候群也可因先天性耳畸形所致。当宽大畸形的前庭导水管导致功能上的障碍时，它不仅可使内淋巴液稀释，内耳电解质失衡，还可能影响内耳免疫机制，但波动性听力下降的原因，目前还不清楚。对儿童眩晕伴感音神经性听力下降患者做诊断时应考虑到先天性耳畸形。并应积极治疗，力求保证患儿能在学语期有一较好的听力。

Abstract Vertigo as a sympotom in children is frequently not well explained,and special examinations such as audiogram and caloric tests are difficult to be carriedout.So the diagnosis not easy in children with vertigo,tinnitis and hearing loss.7 cases with fluctuating hearing loss and vertigo received temporal bone CT scan. The results demonstrated that the vestibular aqueducts(VA)in all 7 children were enlarged.This finding suggests that congen ital inner ear malformation──large vestibular aqueduct may lead to vertigo and hearing loss similar to Meniere,s disease. From our experience,he diagnosis of children with vertigo and hearing loss is difficult,and the large vestibular aqueduct should be considered.Temporal bone CT scan is important in making the correct diagnosis,and intensive treatment should be give as early as possible.