听性脑干反应结合纯音听阈测定对突发性耳聋诊断及预后评估的作用

Effectiveness of auditory brainstem response plus pure tone audiometry in the diagnosis and prognosis of sudden deafness

目的探讨听性脑干反应(ABR)结合纯音听阈测定对突发性耳聋诊断及预后评估的作用。方法选取2016年3月~2017年3月我科收治的50例突发性耳聋患者(共53耳)进行纯音听阈测定,曲线特征表现为:低频下降型14耳,高频下降型13耳,平坦型17耳,极重度型9耳。针对不同类型采取相应的治疗,14 d为1个疗程,然后判定疗效。同时对突发性耳聋患者进行ABR检测;观察ABR阈值与主观阈值的相关性,并且观察ABR波形未引出者(A组,15耳)与ABR波形引出者(B组,38耳)的突发性耳聋患者的治疗效果。结果经过治疗,突发性耳聋患者中痊愈17耳、显效14耳、有效8耳,治疗的总有效率为73.58%。B组突发性耳聋患者ABR波形可引出者,其阈值较主观听阈高10~20 d B,有较好的相关性(Y=1.8623-0.8741X,r=0.8741);B组治疗的总有效率为89.45%,A组的总有效率为33.33%,两组比较差异有统计学意义(χ~2=6.603,P=0.005)。结论 ABR结合纯音听阈测定不仅可用于突发性耳聋患者的诊断及分型,且ABR可作为突发性耳聋预后预测的指标,ABR波形引出者治疗效果好,波形未引出者治疗效果差。

Objective To investigate the effectiveness of combination of application of auditory brainstem response(ABR)and pure tone audiometry(PTA)in the diagnosis and prognosis of sudden deafness.Methods Altogether 50 cases of patients with sudden deafness(53 ears)who were treated in our department from March 2016 to March 2017 underwent pure tone audiometry were selected,and their curve features included low frequency descent type(14 ears),high frequency descent type(13 ears),flat type(17 ears)and extremely severe type(9 ears).Corresponding treatment was given according to the different types,with 14 days for a course of treatment,and then the curative effect was determined.At the same time,ABR of sudden deafness patients was detected to observe the correlation between ABR threshold and subjective thresholds.The therapeutic effect was also observed between sudden hearing loss patients without ABR waveform(group A,15 ears)and with ABR waveforms(group B,38 ears).Results After treatment,17 ears of patients with sudden deafness were cured,14 ears showed effect and 8 ears were effective.The total effective rate of treatment was 73.58%.The threshold of group B patients with ABR waveforms was 10 to 20 dB which was higher than that of subjective threshold,with a good correlation(Y=1.8623-0.8741X,r=0.8741).The total effective rate of group A was 33.33%,and group B was 89.45%,with significant difference between the two groups(χ2=6.603,P=0.005).Conclusion Combination of application of ABR and PTA not only can be used for the diagnosis and classification of patients with sudden deafness,ABR also can be used as indicators to predict the prognosis of sudden deafness.Patients with ABR waveform have good treatment effect,while,patients without ABR waveform have bad treatment effect.