双侧突发性耳聋的临床特征与治疗(附8例分析)

Clinical Characteristics and Treatment of Bilateral Sudden Sensorineural Hearing Loss: A Report of 8 Cases

目的分析双侧突发性耳聋的临床特点和治疗方法。方法回顾性分析2012年1月至2013年6月确诊并接受治疗的8例双侧突发性耳聋患者的临床资料,包括临床表现,听力学检查,影像学检查,血液学检查,治疗方法及效果评估等,探讨双侧突发性耳聋的临床特征及治疗方法。结果 7例双耳同时发病,1例双耳先后发病。白细胞计数异常1例,血液流变学异常5例,风疹病毒、巨细胞病毒、单纯疱疹病毒Ig G抗体异常6例(2例未查),凝血功能均无异常,8例患者纤维蛋白原均升高,血糖增高1例,血脂升高1例。心电图和影像学检查结果均正常。采用分型治疗后,8例患者痊愈1耳,显效0耳,有效0耳,总有效率为6.25%。结论双侧突发性耳聋发病原因多样化,病情复杂,预后较单侧突发性耳聋差,须针对不同类型听力曲线采取分型治疗。

Objective To report characteristics and treatment outcomes in patients with bilateral sudden sensorineural hearing loss （BSSHL）. Methods From Jan 2012 to June 2013, 318 patients with sudden sensorineural hearing loss were treat？ed by the authors. Of these, 8 （2.5%） had BSSHL. We reviewed the charts of these 8 patients, focusing on clinical manifesta？tions, audiologic characteristics, radiography, laboratory results and treatment outcomes. Results Seven of the 8 patients re？ported simultaneous BSSHL, and the other one had sequential BSSHL. Electrocardiogram, CT and MRI were normal in all pa？tients. Abnormal white blood cell count was seen in one case, increased blood viscosities in 5 cases, increased virus antibod？ies in 6 cases, abnormal glucose in 1 case, abnormal lipid metabolism profile in 1 case, and increased fibrinogen levels in all 8 cases. After combined multiple therapies tailored to each patient based on subtypes of audiogram, complete hearing recov？ery was achieved in 1 ear （6.25%）, while the rest showed no responses. Conclusion BSSHL is a complex condition with vari？able etiological factors and poor prognosis. It may need to be treated based upon subtypes of audiogram.