27例复发性急性低频感音神经性听力损失临床特征分析

Clinical Characteristics of 27 Patients with Recurrent Low-tone Sensorineural Hearing Loss

目的通过对复发性急性低频感音神经性听力损失患者的临床特征、辅助检查以及疗效的分析,探讨其临床特征,以期对其进行早期干预,避免患者听力进一步下降,保持较好的听力,并为此类患者的临床研究提供依据。方法回顾性分析我科2013年8月-2018年8月收治的27例(28耳)复发性低频感音神经性听力损失患者的临床资料,并分别于治疗前、治疗后1周、治疗后2周或治疗结束时对患者进行纯音测听检查,以了解患者听力情况。结果27例复发性低频感音神经性听力损失患者中,男性占25.93%(7/27),女性占74.07%(20/27);单耳发病占96.30%(26/27),双耳发病占3.70%(1/27);首次发病平均年龄为31.3±8.03岁;首次发病时耳声发射低频引出率为60%(6/10),第二次为44.44%(4/9);首次治疗时患者发病—治疗时间为11.44±14.69天,第二次为5.15±6.18天,差异有统计学意义(t=2.150,P<0.05);首次发病时听力损失为43.13±10.11 dB HL,复发时为37.78±9.21dB HL,差异有统计学意义(t=2.631,P<0.01);首次发病治疗后听力恢复18.84±10.73dB HL,复发时为25.98±13.60dB HL,差异有统计学意义(t=2.836,P<0.01);首次发病治疗总有效率为78.57%,复发时为53.57%。结论复发性低频感音神经性听力损失好发于年轻女性,以单侧发病居多。随着发病次数增多,患者耳蜗外毛细胞受损增加,其治疗效果逐渐下降,及早治疗有利于听力的恢复。

Objective To report clinical characteristics and treatment outcomes of recurrent acute low-tone sensorineural hearing loss(RALHL)and to provide the basis for clinical research on such patients.Methods Clinical characteristics,audiometric and imaging results and treatment outcomes in 27 patients with recurrent low-tone sensorineural hearing loss admitted to our hospital from August 2013 to August 2018 were reviewed.Results Among the 27 cases,7 were male(25.93%).Hearing loss involved one ear in 26(96.30%)cases and both ears in 1(3.70%)case.The age at the first attack was 31.3±8.03 years.The extraction rate of low-frequency distortion product otoacoustic emissions(DPOAE)was 60%(6/10)at the first attack and 44.44%(4/9)at relapse.The time to visit was 11.44±14.69 days at the first attack,and 5.15±6.18 days at relapse(t=2.150,P<0.05).The average pure tone audiometry threshold before treatment was 43.13±10.11 dB HL at the first attack and 37.78±9.21 dB HL at relapse(t=2.631,P<0.01).The mean post-treatment hearing threshold was 18.84±10.73 dB HL at the first attack and 25.98±13.60 dB HL after relapse(t=2.836,P<0.01).The overall rate effectiveness was 78.57%for the first treatment and 53.57%the second time.Conclusion RALHL tends to affect young adult women unilaterally.As the number of episodes increases,damage to outer hair cells also increases and treatment efficacy declines.Early treatment is beneficial for hearing recovery.