突发性聋继发良性阵发性位置性眩晕的临床观察

A clinical observation of patients with benign paroxysmal positional vertigo after sudden deafness

目的了解继发于突发性聋的良性阵发性位置性眩晕（benign paroxysmal positional vertigo，BPPV）的发病情况并探讨其治疗策略。方法观察眩晕门诊及耳内科病房中心2004年1月-2010年1月收治的210例突发性聋患者（包括伴有眩晕的突发性聋）合并BPPV的发病情况，并与同期183例原发性BPPV相比较。结果本组突发性聋病例并发BPPV为19．0％（40／210）；40例患者均为高频感音神经性聋或平坦型感音神经性聋。本文40例继发于突发性聋的BPPV，出现时间均在突发性聋发病后t周内。继发性BPPV的手法复位效果与原发性BPPV相似，大多数都于1～2次就诊后治愈。结论突发性聋继发的BPPV是临床常见的现象；继发于突聋的BPPV与原发性BPPV都是以后半规管BPPV多见，并与原发性BPPV手法复位的疗效相似。

Objective To investigate the prevalence of benign paroxysmal positional vertigo（BPPV） after the onset of sudden deafness and to explore the appropriate application of treatment strategies. Methods 210 patients with sudden deafness,including those complaining of vertigo,were recruited in the study. The occurrence of BPPV in these patients was observed and their therapeutic findings were compared with the 183 patients with primary BPPV. Results The prevalence of BPPV after the onset of sudden deafness in patients was 19.0%（40/210）. The pure tone audiograms indicated that the subjects with BPPV were with high-frequency or flat sensorineural hearing losses. The BPPV occurred within 7 days after the onset of sudden deafness in all cases. And the therapeutic effects of canalith repositioning maneuver for the secondary BPPV was similar to that for the primary BPPV. Conclusion The BPPV is often secondary to the sudden deafness. The most common type of primary and secondary BPPV was both posterior semicircular canal BPPV. The therapeutic efficacy of canalith repositioning maneuver for the secondary BPPV was similar to that for the primary BPPV.