不同听力曲线类型儿童突发性聋的临床特征分析

Characteristics and curative Effect Analysis of different audiometric Configurations in Children sudden sensorineural hearing Loss

目的分析各型听力曲线类型儿童突发性聋患者的临床特征、疗效及预后,为儿童突发性聋患者的临床诊疗提供个性化的参考依据。方法本文回顾性分析了2014年3月-2019年3月期间在河南省焦作市第二人民医院耳鼻咽喉头颈外科住院治疗、<18岁有较完整临床资料的72例(80耳)儿童突发性聋患者的资料,比较各型听力曲线类型在性别、侧别、伴发症状(耳闷、耳鸣、眩晕)、听力损失程度以及疗效的分布特点。结果 72例(80耳)儿童突发性聋住院患者中,听力损失程度以重度(20耳,25.0%)和极重度(48耳,60%)为主,听力曲线类型分为低频下降型(6耳,7.5%),高频下降型(10耳,12.5%),平坦型(19耳,23.8%),全聋型(45耳,56.2%),以全聋型最多,低频下降型最少。本研究的治疗总有效率为38.8%,低频下降型的有效率为66.7%,高频下降型的有效率为50.0%,平坦型的有效率为42.1%,全聋型的有效率为31.1%。不同类型听力曲线在性别、是否伴有耳闷、疗效的分布上无显著差异(P>0.05),在侧别、听力损失程度、是否伴有耳鸣、眩晕的分布有显著差异(P<0.05)。比较不同听力曲线治疗前后的听力情况,听力水平较治疗前有不同程度的改善。结论儿童突发性聋患者的各型听力曲线类型在性别、侧别、伴发(耳闷、耳鸣、眩晕)症状、听力损失程度以及疗效的分布各有其特点,听力曲线以全聋型最多见,低频下降型最少见;各型听力曲线的儿童突发性聋患者的发病机理不同,其疗效也有不同,低频下降型疗效较好,全聋型最差,因此分型治疗有助于提供个性化的诊疗方案,为听力损失的预防及干预提供参考。

Objective This study was to analyze characteristics, curative effect and prognosis of different audiometric configurations in children sudden sensorineural hearing loss(CSSNHL), and provide the reference for the clinical diagnosis and treatment. Methods Retrospective analyze of 72 cases(80 ears) of CSSNHL(from March 2014 to March 2019) in the second people’s hospital of Jiaozuo, compared the gender, side, ear fullness, tinnitus, vertigo, initial hearing level and curative effect in different audiometric configurations. Results Of the 72(80 ears) hospitalized children with sudden deafness, the hearing loss was mainly severe(20 ears, 25.0%) and extremely severe(48 ears, 60%). The hearing curve types were divided into low frequency decline type(6 ears, 7.5%), high frequency decline type(10 ears, 12.5%), flat type(19 ears, 23.8%), total deafness type(45 ears, 56.2%), with total deafness type being the most and low frequency decline type being the least. The total effective rate of treatment in this study is 38.8%, 66.7% for low frequency falling type, 50.0% for high frequency falling type, 42.1% for flat type and 31.1% for total deafness type. There was no significant statistical difference in the distribution of sex, ear tightness and curative effect of different types of hearing curves(P > 0.05), but there was significant statistical difference in the distribution of side, hearing loss degree, tinnitus and vertigo(P < 0.05). Compared with the hearing situation before and after treatment with different hearing curves, the hearing level has been improved to different degrees. Conclusion The characteristics and curative effect are different in CSSNHL with different audiometric configurations. Profound audiogram configuration was the most, ascending audiogram configuration was the least. The curative effect of ascending audiogram configuration was the best, profound audiogram configuration was the worst. Therefore, classification treatment according to audiogram configurations types helps to provide targeted prevention and intervention measures.