感音神经性聋伴耳鸣患者中耳蜗坏死分布的影响因素

Influencing factors of cochlear necrosis distribution in patients with sensorineural hearing loss and tinnitus

目的分析感音神经性聋伴耳鸣患者耳蜗坏死分布的影响因素。方法选取2018年1月至2019年12月间惠州市第一人民医院耳鼻喉科诊治的感音神经性聋伴耳鸣患者150例(240耳)作为病例组,以同期健康检查且正常听力者25例(50耳)作为对照组。采用均衡噪声阈值检测耳蜗死区,分析患者的性别、年龄、听力损失程度及病程之间的关系。结果病例组耳蜗死区检出率41.33%,对照组未检出耳蜗死区(P<0.05)。病例组患者的不同年龄、性别间耳蜗死区检出率无差异(P>0.05)。听力损失重度者耳蜗死区检出率58.06%,明显高于中度(27.42%)和轻度(14.52%)听力损失者(P=0.000、0.000),病程>14 d患者耳蜗死区检出率(50.00%)高于病程<7 d的患者(16.13%)(P<0.05)。结论感音神经性聋伴耳鸣患者存在耳蜗死区,与患者的年龄、性别无关,与听力损失程度和病程相关,且听力损失程度越重、病程越长,耳蜗死区发生率越高。

Objective To analyze the factors affecting the distribution of cochlear necrosis in patients with sensorineural hearing loss and tinnitus.Methods A total of 150 patients(240 ears)with sensorineural hearing loss and tinnitus diagnosed and treated by the Department of Otolaryngology.Huizhou First People's Hospital from January 2018 to December 2019 were selected as the case group.and 25 patients with normal hearing during the same period of health examination cases(50 ears)served as a control group.The balanced noise threshold was used to detect the cochlear dead zone and the relationship between the patient's gender.age.hearing loss degree and disease course was analyzed.Results The detection rate of cochlear dead zone in the case group was 41.33%,and no cochlear dead zone was detected in the control group(P<0.05).There was no difference in the detection rate of cochlear dead zone among patients of different ages and genders in the case group(P>0.05).The detection rate of cochlear dead zone in patients with severe hearing loss is 58.06%,which is significantly higher than that in patients with moderate(27.42%)and mild(14.52%)hearing loss(P=0.000,0.000).The detection rate of cochlear dead zone in patients with course of disease>14 days the rate(50.00%)was higher than that of patients with a course of less than 7 days(16.13%)(P<0.05).Conclusion The cochlear dead zone is common in patients with sensorineural hearing loss and tinnitus.which has nothing to do with the age and gender of the patient.but is related to the degree of hearing loss and the course of the disease.The more severe the patient’s hearing loss and the longer the course of the disease.the higher the incidence of cochlear dead zone.