儿童突发性聋患者的临床特征及预后分析

Analysis of Clinical Characteristics and Prognosis for Sudden Sensorineural Hearing Loss in Children

目的分析儿童突发性聋(简称突聋)患者的临床特征及预后,为该病的临床诊治提供参考。方法回顾性分析2008年1月~2016年10月确诊并治疗的23例(25耳)儿童突聋患者的临床资料,对所有患者的年龄、性别、耳别、就诊时间、病毒感染史、就诊时言语频率气导纯音听阈及听阈曲线类型、是否伴有耳鸣、眩晕、耳闷及治疗效果进行统计分析,并与同期住院治疗的202例(219耳)成人突聋患者进行对比。结果本组儿童突聋患者占同期所有突聋患者的10.2%(23/225);儿童突聋患者就诊时平均听阈(87.7±16.1dB HL)、全聋型比例(72.0%)、眩晕伴发率(52.2%)及病毒感染率(17.4%)均高于成人(分别为72.5±24.7dB HL、44.7%、29.2%、3.5%),差异均有统计学意义(均为P<0.05)。治疗后儿童突聋患者与成人患者的总有效率分别为52.0%、46.6%,痊愈率分别为4.0%、14.2%,差异均无统计学意义(P>0.05)。结论本组儿童突聋患者就诊时听力损失较重且常伴有耳鸣及眩晕,其听阈曲线以全聋型为主;疗效与成人突聋患者相当。

Objective To study the clinical characteristicsand prognosis in pediatric sudden sensorineural hearing loss and provide guidance for clinical practice.Methods We retrospectively analyzed the clinical data of 23 pediatric sudden sensorineural hearing loss patients(25 ears)treated in our department during the past 9 years(from January 2008 to October 2016).Comparatively we looked into those related factors(age,gender,ear side,treatment onset,initial hearing threshold,virus infection history,audiogram configuration,presence of tinnitus,vertigo,ear fullness and recovery)between pediatric patients and 202 adult patients(219 ears).Results Pediatric patients comprised 10.2% of pediatric/adult cases of sudden sensorineural hearing loss.The average hearing threshold(87.7±16.1 dB),rate of presence of vertigo(48.0%)and rate of virus infectionin in the pediatric group,were significantly higher than those of in the adult group(P<0.05).Tinnitus occurred in 80% of pediatric patients,and96% of the audiogram configurations showed total deafness curves and flat lines.After positive treatment,the overall recovery rate of the pediatric and the adult group were 52.0%and 46.6%,and the rate of complete recovery was4.0% and 14.2%,respectively.The difference was not statistically significant(P>0.05).Conclusion Pediatric sudden sensorineural hearing loss was generally identified as severe hearing loss with a high rate of presence of tinnitus and vertigo,and most audiogram configurations were total deafness in flat lines.Virus infection probably is one of the primary etiologies for sudden sensorineural hearing loss in children.