突发性聋并发良性阵发性位置性眩晕的临床分析

Patients with Idiopathic Sudden Sensorineural Hearing Loss and Comorbid Benign Paroxysmal Positional Vertigo

目的研究突发性聋并发BPPV(benign paroxysmal positional vertigo,BPPV)的临床特点及预后,探讨其可能发病机制。方法回顾性研究198例突发性聋患者的临床资料,根据有无眩晕、眩晕特点和变位试验结果确诊是否并发BPPV,分析突发性聋并发的BPPV的临床特点及预后,并与同期59例原发性BPPV进行比较。结果 28例全聋型突发性聋并发BPPV,BPPV发病均在突聋后1周内,最常见类型是水平半规管BPPV,其次是后半规管BP-PV,而原发性BPPV最常见类型是后半规管BPPV,其次是水平半规管BPPV;突发性聋并发的BPPV手法复位的治愈率和复发率与原发性BPPV相似。结论突发性聋并发的BPPV最常见类型是水平半规管BPPV,其次是后半规管BPPV;其手法复位的治愈率和复发率与原发性BPPV相似。

Objective To report clinical features and treatment outcomes in patients with idiopathic sudden sensorineural hearing loss(ISSNHL)with comorbid benign paroxysmal positional vertigo(BPPV)and to hypothesize possible pathophysiology of this disease entity.Methods Clinical data of 198 ISSNHL patients were investigated retrospectively.BPPV was identified based on the symptom of vertigo and results of positional tests.Patients with both ISSNHL and BPPV were designated as group A and patients with only idiopathic BPPV as group B(n=59).Clinical features and outcomes were compared between the two groups.Results In group A,the lateral semicircular canal was more often involved than the posterior semicircular canal;in contrast,the posterior semicircular canal was more frequently involved than the lateral semicircular canal in group B.However,treatment outcomes and rate of recurrence were similar between the two groups.Conclusions Lateral semicircular canal is more often involved than the posterior semicircular canal in patients with ISSNHL and comorbid BPPV,although treatment outcomes and recurrence of this disease entity are similar to idiopathic BPPV.