不同类型单侧突发性聋患者内淋巴积水研究

Endolymphatic Hydros in Patients with Different Types of Unilateral Sudden Deafness

目的探讨突发性聋患者的内耳膜迷路是否积水,及其与听力曲线类型、耳闷程度的关系。方法选择发病2周内的单侧突发性聋患者20例(低频下降型、高频下降型、平坦下降型和全聋型各5例),测量所有被试内听道核磁影像片上内耳前庭区及耳蜗内淋巴间隙值,并行耳闷程度评分(visual analogue scale/score,VAS),进行统计学分析。结果20例单侧突发性聋患者的受检耳包括左、右耳各10例,其中8例(40%,8/20)伴有耳闷症状,不同类型突发性聋的耳闷发生率依次为低频型(80%,4/5)高于平坦型(40%,2/5)、全聋型(40%,2/5)和高频型(0,0/5),其发生率不具有统计学差异(P>0.05);2例低频下降型突发性聋患者的受检耳前庭部内淋巴积水,余均未见积水表现;突发性聋分型与患侧前庭区、耳蜗区内淋巴比值结果均不具有统计学差异(P>0.05)。低频型患者更易出现耳闷症状且耳闷程度与内淋巴积水具有相关性(r=0.622,P<0.05)。结论突发性聋患者存在内淋巴积水,尤其是低频下降型,耳闷程度越重提示内淋巴积水程度可能越重。

Objective To investigate endolymphatic hydrosor in patients with different types of unilateral sudden deafness and the relationship with the type of hearing curve and the degree of ear fullness.Methods 20 cases of sudden deafness within 2 weeks of onset were selected,the interlymphatic space of vestibular and cochlea of inner ear was measured on the MRI results of internal auditory canal of all subjects,and the score of ear fullness VAS was compared to statistically analyze the correlation between the two.Results There were 20 cases of unilateral sudden deafness,including 10 cases of left ear and 10 cases of right ear,among which 8 cases(40%,8/20)were accompanied by symptoms of ear fullness.The incidence of ear fullness in low frequency type(80%,4/5)was more than that in flat type(40%,2/5),in total deafness type(40%,2/5)and in high frequency type(0,0/5).There was no statistical difference(P>0.05).2 cases of low frequency sudden deafness had endolymphatic hydros in the vestibular of the affected side,and no endolymphatic hydros was found in the rest.There was no significant difference in the lymphoid ratio between the type of sudden deafness and the vestibular area and cochlea area of the affected side(P>0.05).Low-frequency patients were more likely to have symptoms of ear fullness,and the degree of ear fullness was correlated with endolymphatic hydros(R=0.622,P<0.05).Conclusion Endolymphatic hydros exists in patients with sudden deafness,especially in patients with low-tone sensorineural hearing loss.The more severe the degree of ear fullness is,the more severe the degree of endolymphatic hydros may be.