全聋型突发性聋患者的临床特征及转归分析

Analysis of Clinical Characteristics and Outcomes in Total Sudden Deafness

目的 探究全聋型突发性聋患者的临床特点,包括全身状况、诱因、病史及疗效分析。方法 对2017年3月至2021年5月以全聋型突发性聋收入院的患者进行回顾性分析,将患者的基本信息、发病特点及治疗效果进行分组比较并用SPSS 20.0软件进行统计分析。结果 1、耳聋侧别及性别分布:表现为单侧全聋型突发性聋(81例),其中左侧41例(50.62%)、右侧40例(49.38%);男性43例(53.09%)、女性38例(46.91%);2、伴随症状:耳鸣69例(85.19%)、眩晕57例(70.37%)、耳闷41例(50.62%)、耳周麻木感14例(17.28%)、听觉过敏1例(1.23%)、头痛1例(1.23%);3、诱因:有明确诱因28例(34.57%),分别为劳累11例(13.58%)、熬夜5例(6.17%)、发热、感冒、外伤、情绪、疼痛及酗酒各为2例(各占2.47%),无明确诱因53例(65.43%);4、影像学结果:56例有完整内听道磁共振结果,其中41例未见异常,15例异常;54例有完整颈动脉超声结果,其中33例未见异常,21例异常;5、整体疗效分析:无效64例(79.01%)、有效13例(16.05%)、显效4例(4.94%),总有效率为20.99%;6、各分组有效率比较:按病程、性别、侧别、有无诱因、有无病史分组,病程组有统计学差异(P<0.05),其余各组均无统计学差异(P>0.05);7、分频率(0.125-8kHz)疗效分析:低频痊愈率最高,总有效率高频8kHz略高,其次是中低频,1kHz最低。结论 全聋型突发性聋患者多无明确诱因且整体疗效欠佳,多伴有耳鸣、眩晕、耳闷等症状,病程对疗效有一定影响;部分患者内听道磁共振和颈动脉超声结果有异常表现。

Objective To report clinical characteristics of patients with total sudden deafness, including systemic conditions, causes, medical history and therapeutic outcomes. Methods Data from patients admitted with total sudden deafness from March 2017 to May 2021 were retrospectively analyzed. Patients were grouped based on basic information, clinical characteristics and therapeutic outcomes and compared using the SPSS 20.0 software. Results Deafness was unilateral in 81 patients, involving the left side in 41(50.62%) and right side in 40(49.38%). Forty three(53.09%)of the patients were male and 38(46.91%) were female. Tinnitus was the most common accompanying symptom(n=69, 85.19%), followed by vertigo(n=57, 70.37), ear fullness(41, 50.62%), periauricular numbness(n=14, 17.28%);hyperacusis(1, 1.23%) and headache(1, 1.23%). A clear etiology correlation could be identified in 28 cases(34.57%), including exhaustion(n=11, 13.58%), staying up late(n=5, 6.17%), fever(2, 2.47%), common cold(2, 2.47%), trauma(2,2.47%), emotional episodes(2, 2.47%), pain(2, 2.47%) and alcoholism(2, 2.47%). No definite etiology could be identified in the other 53 cases(65.43%). MRI of the internal auditory canal was completed in 56 cases, normal in 41 and abnormal in 15. Carotid ultrasonography data were available in 54 cases, o normal in 33 and abnormal in 21. Treatment resulted in no change in 64 cases(79.01%), some improvement in 13 cases(16.05%), and significant improvement in 4cases(4.94%), yielding a total rate of effectiveness of 20.99%. Treatment outcomes showed some degree of correlation to disease course(P<0.05), but not to other variables(P>0.05). The rate of complete recovery was the highest for low frequencies, although the overall rate of effectiveness was slightly higher for high frequency(8 kHz), followed by middle and low frequencies with the lowest at 1 kHz. Conclusion In most patients with total sudden deafness, no clear causes can be identified and the overall treatment outcomes are poor. Many of them also present with tinnitus, vertigo and ear fullness. The course of disease may have a certain impact on treatment outcomes. Some patients may have abnormal findings on internal auditory canal MRI and/or carotid ultrasound.