神经耳科学检查对听神经瘤的诊断意义

Neurootologic study of acoustic neuroma

目的 :探讨神经耳科学检查对听神经瘤的诊断意义。方法 :对 13例听神经瘤行纯音测听、声导抗、眼震电图、听性脑干诱发电位 ( ABR)、耳蜗电图及面神经电图等神经电生理检查。结果 :患侧纯音听阈 1例正常 ,另 4例 2 k Hz以下在正常范围 ;声导抗镫肌反射试验结果不一 ,冷热试验 8例患侧半规管麻痹 ,均伴有一项或多项视 -前庭眼动眼震异常 ;ABR2例未能引出 ,敏感度为 90 .9% ;7例面神经电图异常 ;3例行耳蜗电图和 2例行耳声发射均有阳性发现。结论 :神经耳科学检查对听神经瘤的筛选诊断具有重要意义 ,但对检查结果须综合考虑 。

Objective:To summarize the outcome of neurootologic examination of acoustic neuroma and study of diagnostic significance of neurootologic examination on acoustic neuoma.Method:13 patients were examined with pure tune test,acoustic immittance,electronystagmography,acoustic brainstem evoked response,electrocochleogram,otoacoustic emissions and facial electronurography.Result:All patients had subjective hearing loss.One patient had normal pure tone audiogram,other 4 patients had normal pure tone test at the frequency <2000 Hz.The outcome of acoustic immittance is various.5 patients were normal in caloric test,but all were abnormal in visual vestibular optokinetic response.ABR are positive in 90.9 % of cases,but 2 patients had no response.7 patients were abnormal in facial electroneurography,3 (of 3) eletrocochleogram and 2 (of 2) otoacoustic emissions revealed retrocochlear patholgoy.Conclusion:Neurootologic examination played important role in filtering diagnosis of acoustic neuroma,results should be considered synthetically,acoustic neuroma should not be ruled out if any one test was negative.