小儿突发性聋的临床特征分析

Clinical Features of Sudden Deafness in Children

目的 探讨小儿突发性聋的病因、临床症状及治疗转归等临床特征。方法 回顾性总结12例（18耳）年龄在14岁以下突发性聋患儿的发病年龄分布、发病至就诊间隔时间、听力损害程度与治疗转归间可能的相关因素。结果 ①本组12例突发性聋患儿，发病时平均年龄8．18岁，发病至就诊间隔时间平均为12天，能在发病1周内及时就诊者仅4例（33．33％），均通过影像学排除耳部及颅内畸形；②本组突发性聋患儿可能的发病诱因中，有上呼吸道感染病史者4例（33．33％），有高热、外伤、游泳史者各1例，无明显诱因者5例（41．67％）；③在完成全部治疗疗程的8例（14耳）患儿中，4例（6耳）主观听觉（自诉和／或家长主诉）和客观听力（ABR）有改善，ABR波Ⅴ反应阈值下降幅度在15～35dB之间。结论 学龄期儿童突发性聋的诊断相对于学龄前期儿童在临床上较易获得；上呼吸道感染是小儿突发性聋发病中一个不容忽视的诱因；小儿比成人突发性聋发现和接受治疗较迟，这可能是小儿突发性聋患者听觉恢复效果不佳的一个重要原因。

Objective To investigate the etiology, clinical symptom and therapeutic efficacy in children with sudden deafness. Methods： A retrospective review of medical records was performed on twelve children（ 18 ears ） under fourteen years old who presented with sudden hearing loss. Age distributions, the duration between the onset of hearing loss and the beginning of treatment and initial hearing level were recorded and analyzed. Results ① The average duration between the onset of hearing loss and the beginning of treatment was 12 days, only 4 patients（33.33% ） of the twelve children of average 8.18 years underwent treatment within one week of the onset of symptoms. ② Four children（33.33% ） had a history of upper respiratory infections, 5 children（41.67% ） had no causes. The other had a history of fever, external injury and swimming in three children,respectively. ③Among the 18 ears, the hearing loss of 16 ears（88.89% ） were profound,2 ears（11.12% ） were moderate. The elevated subjective and objective hearing level occurred in 4 children（6 ears） of 8 children who received complete treatment, with the threshold of wave V descending from 15 dB nHL to 35 dB nHL. Conclusion School age children are easier to be diagnosed than pre - school age children. Virus infection may play a role in pathogenesis of sudden deafness. The poor prognosis in children with sudden deafness may be due to the delayed treatment.