伴有和不伴有眩晕的突发性聋纯音测听检测结果研究(1)
摘 要：目的 检测伴有和不伴有眩晕的突发性聋患者的纯音听阈表现，分析突发性聋发病时伴有眩晕或不伴有眩晕时纯音听阈的特点，研究两者纯音听阈检测结果的差异性。方法 将2015年1月～2017年1月我科诊治的突發性耳聋116例患者分为眩晕组和不伴眩晕组，分别详细询问病史后，对患者进行电耳镜检查，纯音听阈测听，声导抗测听，耳声发射及内听道MRI检查，排除外耳，中耳及中枢性病变，记录患者检测数据后进行统计分析。结果 突发性聋伴有眩晕患者纯音测听检查结果多提示有高频听阈的提高，而不伴有眩晕的突发性聋患者纯音测听无特异性及规律性。结论 在临床治疗过程中，伴有眩晕的患者恰好听阈改变多在高频区。针对性治疗耳蜗底部受损这一特点所致突发性耳聋患者，可能对我们医学科研及临床的诊断和治疗工作有参考价值。
关键词：眩晕；突发性耳聋；纯音测听；高频听阈
中图分类号：R764 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.04.033
, http://www.100md.com
文章编号：1006-1959(2018)04-0100-02
Abstract：Objective To detect the pure tone hearing threshold of sudden deafness with and without vertigo， and to analyze the characteristics of pure tone hearing threshold in sudden deafness with or without vertigo，we studied on the differences of the two threshold detection results.Methods From January 2015 to January 2017，116 patients with sudden deafness in our hospital were divided into vertigo group and non-vertigo group.After a detailed inquiry into the history of the disease，the patients were examined by electroscope，pure tone threshold audiometry，acoustic conductance audiometry，otoacoustic emission and MRI examination of internal auditory canal to exclude external ear，middle ear and central lesions.The data were recorded and analyzed.Results The results of pure tone audiometry in patients with sudden deafness and vertigo showed that there was an increase in high frequency hearing threshold， but there was no specificity and regularity in pure tone audiometry in patients with sudden deafness without vertigo.Conclusion In clinical treatment，patients with vertigo just hearing changes in high frequency region.Targeted treatment of sudden deafness due to the characteristics of cochlear bottom injury may be valuable for our medical research and clinical diagnosis and treatment.
, 百拇医药
Key words：Vertigo；Sudden deafness；Pure tone audiometry；High frequency hearing threshold
突发性耳聋(sudden deafness)一般是指突然发现的感音神经性听力损失，通常在数分钟、数小时或3 d之内，患者听力下降至最低点，至少在相连的频率听力下降大于20 dB，常伴有耳鸣[1]。而突发性耳聋伴有的眩晕一般是指排除中枢性的周围性眩晕，周围性眩晕是由内耳迷路或前庭部分、前庭神经颅外段(在内听道内)病变引起的，其特点之一为常伴耳鸣、听觉障碍，而无脑功能损害。包括急性迷路炎、梅尼埃病等。另外还具有如下特点：①眩晕为剧烈旋转性，持续时间短，头位或体位改变可使眩晕加重明显；②眼球震颤：眼震与眩晕发作同时存在，多为水平性或水平加旋转性眼震。通常无垂直性眼震，振幅可以改变，数小时或数日后眼震可减退或消失，向健侧注视时眼震更明显。头位诱发眼震多为疲劳性，温度诱发眼震多见于半规管麻痹；③平衡障碍：多为旋转性或上下左右摇摆性运动感，站立不稳，自发倾倒，静态直立试验多向眼震慢相方向倾倒；④自主神经症状：如恶心、呕吐、出汗及面色苍白等。
1 资料与方法
1.1一般资料 突发性耳聋患者在临床的诊治过程中首先需要行纯音听阈检查，纯音测听中的高频听阈是指用听力检测设备检测听力时测的在某个频率点上最小能听到的声音，听力测试一般会测一下几个频率：125 Hz、250 Hz、500 Hz、1000 Hz、2000 Hz、4000 Hz、8000 Hz，其中2000 Hz以后属于高频，高频声音比较尖，高频听阈提高就是现在高频测得的最小能听到的声音比之前测的大，就是高频部分听力变差[2]。纳入标准：①耳科及听力学评估：无中耳疾病，无先天性耳聋家族史，常规检查外耳道及鼓膜均正常，声导抗检查鼓室图为“A”型图，20～80岁年龄组；②所有受试者无其他神经系统和认知障碍疾病史。, http://www.100md.com(王莉 徐庆 娄佑云)
关键词：眩晕；突发性耳聋；纯音测听；高频听阈
中图分类号：R764 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.04.033
, http://www.100md.com
文章编号：1006-1959(2018)04-0100-02
Abstract：Objective To detect the pure tone hearing threshold of sudden deafness with and without vertigo， and to analyze the characteristics of pure tone hearing threshold in sudden deafness with or without vertigo，we studied on the differences of the two threshold detection results.Methods From January 2015 to January 2017，116 patients with sudden deafness in our hospital were divided into vertigo group and non-vertigo group.After a detailed inquiry into the history of the disease，the patients were examined by electroscope，pure tone threshold audiometry，acoustic conductance audiometry，otoacoustic emission and MRI examination of internal auditory canal to exclude external ear，middle ear and central lesions.The data were recorded and analyzed.Results The results of pure tone audiometry in patients with sudden deafness and vertigo showed that there was an increase in high frequency hearing threshold， but there was no specificity and regularity in pure tone audiometry in patients with sudden deafness without vertigo.Conclusion In clinical treatment，patients with vertigo just hearing changes in high frequency region.Targeted treatment of sudden deafness due to the characteristics of cochlear bottom injury may be valuable for our medical research and clinical diagnosis and treatment.
, 百拇医药
Key words：Vertigo；Sudden deafness；Pure tone audiometry；High frequency hearing threshold
突发性耳聋(sudden deafness)一般是指突然发现的感音神经性听力损失，通常在数分钟、数小时或3 d之内，患者听力下降至最低点，至少在相连的频率听力下降大于20 dB，常伴有耳鸣[1]。而突发性耳聋伴有的眩晕一般是指排除中枢性的周围性眩晕，周围性眩晕是由内耳迷路或前庭部分、前庭神经颅外段(在内听道内)病变引起的，其特点之一为常伴耳鸣、听觉障碍，而无脑功能损害。包括急性迷路炎、梅尼埃病等。另外还具有如下特点：①眩晕为剧烈旋转性，持续时间短，头位或体位改变可使眩晕加重明显；②眼球震颤：眼震与眩晕发作同时存在，多为水平性或水平加旋转性眼震。通常无垂直性眼震，振幅可以改变，数小时或数日后眼震可减退或消失，向健侧注视时眼震更明显。头位诱发眼震多为疲劳性，温度诱发眼震多见于半规管麻痹；③平衡障碍：多为旋转性或上下左右摇摆性运动感，站立不稳，自发倾倒，静态直立试验多向眼震慢相方向倾倒；④自主神经症状：如恶心、呕吐、出汗及面色苍白等。
1 资料与方法
1.1一般资料 突发性耳聋患者在临床的诊治过程中首先需要行纯音听阈检查，纯音测听中的高频听阈是指用听力检测设备检测听力时测的在某个频率点上最小能听到的声音，听力测试一般会测一下几个频率：125 Hz、250 Hz、500 Hz、1000 Hz、2000 Hz、4000 Hz、8000 Hz，其中2000 Hz以后属于高频，高频声音比较尖，高频听阈提高就是现在高频测得的最小能听到的声音比之前测的大，就是高频部分听力变差[2]。纳入标准：①耳科及听力学评估：无中耳疾病，无先天性耳聋家族史，常规检查外耳道及鼓膜均正常，声导抗检查鼓室图为“A”型图，20～80岁年龄组；②所有受试者无其他神经系统和认知障碍疾病史。, http://www.100md.com(王莉 徐庆 娄佑云)