以双侧突发性听力下降为首发症状病例的处理

Management of Patients with Bilateral Sudden Hearing Loss as a Initial Symptom

目的提高对双侧突发性听力下降的诊断和治疗水平方法收集和分析自2003年7月～2005年7月,双侧突发性听力下降14例其中2例发生于妇科手术后,2例流行性腮腺炎后,5例精神性聋,5例为大前庭水管综合征患者。结果 14例患者发病时均为极重度聋或全聋。均有明显的发病诱因,无一例为严格意义上的突发性耳聋 5例精神性耳聋患者治疗后听力正常。5例大前庭水管综合征患者,2例听力恢复正常,2例听力恢复到发病前水平,1例听力无改善。2例妇科手术后患者,1例听力部分恢复,1例治疗无效。2例流行性腮腺炎患者,治疗后听力无改善。结论双侧突发性耳聋的发病率低,应重视双侧突发性听力损失的诱因分析,精神性耳聋和大前庭水管综合征形成的突发性听力下降治愈率较高。

Purpose To raise the level of diagnosis and treatment of bilateral sudden hearing loss. Methods The data of fourteen patients with bilateral sudden hearing loss from July, 2003 to July 2005 in this hospital were analyzed retrospectively, in which 2 patients with hearing loss as a sequel of menoperation on uterine tumor or ovary adherence; 2 cases occurred after mumps; 5 cases were psychiatrical deafness; and 5 cases were diagnosed as enlarged vestibular aqueduct syndrome. Results All the 14 patients showed profound or total bilateral hearing loss at the initial stage, and the hearing loss was found to be induced by some certain factors. Hearing recovery was found in all the patients with psychiatrical deafness. Among the 5 patients with enlarged vestibular aqueduct syndrome two recovered to normal hearing, two recovered partially and one did not recover at all. In the two patients with sudden hearing loss occurring after operation, one recovered from hearing loss and the other did not. No any recovery of hearing was found in the two patients with mumps. Conclusion The incidence of bilateral sudden deafness is relatively low. Some certain inducing factors are connected with bilateral sudden hearing loss. The cure rate of bilateral sudden hearing loss of psychiatrical deafness and enlarged vestibular aqueduct syndrome is realtively high. （ Chin J Ophthalmol and Otorhinolaryngol, 2006,6 ： 291 - 293 ）