122例听神经瘤患者听力受损相关因素分析

Factors Related to Hearing Impairment in Acoustic Neuroma Patients:A Review of 122 Cases

目的分析听神经瘤患者听力受损相关因素。方法回顾性分析122例单侧听神经瘤患者MRI,颞骨CT及听力学检查结果(纯音听阈及言语识别率),根据术前纯音听阈≤50dB、言语识别率≥50%的标准将患者分为实用听力组和无实用听力组,比较两组患者肿瘤大小、肿瘤囊变、脑干受压移位、瘤周有无水肿、内听道宽度、内听道长度、内听道底有无脑脊液等因素。结果内听道扩大程度与听力受损明显相关(P<0.001),肿瘤大小(P=0.25)、脑干受压移位(P=0.38)、瘤周有无水肿(P=0.91)、内听道长度(P=0.75)、内听道底有无脑脊液与听力受损无明显相关(P=0.18);肿瘤囊变可能有相关,但两组患者无统计学意义(P=0.08)。结论内听道扩大的程度与听神经瘤患者听力受损明显相关,其在一定程度上反应了内听道内耳蜗神经长时间受压情况。

Objective To report factors related to hearing impairment in patients with acoustic neuroma. Methods MRI, temporal bone CT and audiologic results in 122 patients with unilateral acoustic neuroma were retrospectively studied. Using the criteria of pure tone thresholds ≤ 50 d B HL and speech discrimination scores ≥ 50%, patients were divided into a serviceable hearing group and a non-serviceable hearing group. Tumor size, cystic change, displacement of brainstem, peritumoral edema, width of internal auditory canal, length of internal auditory canal and cerebrospinal fluid at the fundus of internal auditory canal were compared between these two groups. Results The degree of internal auditory canal enlargement was significantly correlated with hearing loss(P<0.001). Tumor size(P=0.25), displacement of brainstem(P=0.38), peritumoral edema(P=0.91), length of internal auditory canal(P=0.75) and cerebrospinal fluid at the fundus of internal auditory canal(P=0.18) were not significantly correlated with hearing loss. Tumor cystic degeneration may be correlated to hearing loss, but with no statistically significant difference(P= 0.08). Conclusion The degree of the internal auditory canal enlargement is significantly related to the impairment of hearing in patients with acoustic neuroma, and, to some extent, may reflect long-term compression of the cochlear nerve in the internal auditory canal.