9 - (3),,,,,,.% 7, 6, 7,, 7, >7, ;,, ;,,,, (P <.) 3 ; IgE 3 ; ; 3 7,,,, ; ; ; ; R76.37 A 67-9()-9- A clinical and prognosis analysis for bilateral sudden sensorineural hearing loss WAG Qiu-ju, LA Lan, HA Bing, WAG Da-yong, LI Qian, DIG Hai-na, LI a, ZHAO Yang, HA Dong-yi. YAG Wei-yan Department of Otolaryngology, Head and eck Surgery, Chinese People's Liberation Army General Hospital, Beijing 3, China Abstract Objective To analyze the clinical characteristics and prognosis, impact factors of patients with bilateral sudden sensorineural hearing loss (BSSHL). Methods Clinical data of cases of patients with BSSHL were analyzed systematically, including all the clinical manifestations, audiologic characteristics, hematology, iconography, treatment methods and effect assessment. Base on those, we summarized comprehensively the development and prognosis characteristics of the disease. Results The total effective rate was.%, ears in patients cured, effective one ear. In patients, 7 cases with simultaneous BSSHL, cases with sequential BSSHL, and 6 cases with clear incentives. :,, 96,,,, -,,,,,,, Y, 6 7,,, 63,, SCI 6 Email:wqcr@63.net : (33), ( 3673 & 3773), (77) (6BAIB6 & 7BAIB)
Chinese Journal of Otology Vol., o., Initial symptoms showed hearing loss in ears, tinnitus in 7 ears and vertigo in ears. Hearing curve of ears showed decline type, treatment is effective in case, others void; full deaf type ears, notch type ears, treatment fails; hill type ear, flat ears, both were healed. cases had abnormal white blood cell count. The degree of hearing loss, tinnitus evaluation between patients with abnormal and normal white blood cell count was statistically significant difference (P <.). Abnormal antibodies and IgE abnormally increased in 3 cases separately. Serum thyroid stimulating hormone abnormally increased in one case; glucose increased in 3 cases. There were 7 cases with serum lipid and lipoprotein abnormalities, and cases with abnormal lipid metabolism. Conclusion BSSHL has complex condition; the prognosis for improvement is poor, so it helps to develop individualized treatment programs by detailed analysis of the history, clinical characteristics and specific examination of blood and immune system. Key words Deafness; Sudden; Hearing loss; Tinnitus; Vertigo (Bilateral sudden sensorineural hearing loss, BSSHL), Bravo) [],, : ~ db HL; : BSSHL ~ 7 db HL; :7 ~ 9 db HL; : 9 db.7% ~.9% [-],.% ~.3% [6-7] :, BSSHL ( > 9 db HL),.., EB BSSHL, ; 6-36, BSSHL, 3.9% BSSHL.., BSSHL,,., 3.9% ( / 36). AB R (IHS6) (icolet HL; > db HL..3 CT MRI ( ) B [] : :. - khz, ; : > 3 db, : > ~ 3dB, : 6 - < db :.3 PASW., [], BSSHL : (), P <. ; (), 3 ; (3), db ; (),. BSSHL,, 7,, ~ 7, 3 7, :.. (GSI-6),, (GSI Tympstar) (, 7, ) (Madsen),
() / / 3 6 / 3 7 7 9 / 3 / / / 3 3 6 / / 6 / 3 / / / / / / / 3 3 / 6 / / / / 3 / / 6 7 3 / / 6 / / / / 6 / / 9 3 37 9 / 9 / 3 6 / 6 3 / / / /
Chinese Journal of Otology Vol., o., ( ); 6,, ( ),,. BSSHL ( ); (6 ), ; (3 ), (3 ), : ( ),,,, A, AS, C DPOAE, ( ), 7,,,,.3 (6 9 ), ; CT MRI.% ; 6%, % B,, (6 ), ( ),., ; 6 3 -. BSSHL,,,, PBmax %~% () ; 3, ;, ; 6, ; 7 : ( ),,, IgE 3, ;, ;, IgA (6 ) ;,, A EB,, ; AS, C,, : 3 7,.6
3
Chinese Journal of Otology Vol., o., 3 IgA (mg / dl) ( -9 / L) ( -9 / L) (g / L) IgE (IU / ML) EB (IU / ml) (IU / ml ) (g / L) 3 6 7 9 : ; ; ; r- (a) (mmol / L) (mmol / L) A(g / L) (g / L) B(g / L) (mmol / L) (mmol / L) (mg / dl) (μmol / L) (U / L) (U / L) (U / L) (U / L) 3 6 7 9 : ; ;
/ ABCDEJPQ / / / BDFCH 7 / 3 / ABCDHIJ 9 / / ACDEFGK / 9 / / ABCDEGMI / / / 6 ABCFH / 3 7 ABCDEFI / ABCDGLO / / 9 9 ABCDEFHILM / / / / ABCDFKLJ / ABCDEGIP / ABCDEFGO / : A- ; B- ; C- ; D- ; E- / F- ; G- ; H- ; I- ; J- ( ); K- / ATP / A; L- ; M- ;- ; O- ; P- ; Q- [6-7] 6 (, BSSHL ) ( ), 3.9%.%, John Xenellis [], 7.%,, BSSHL.% ~.3%,,,, (P >.), BSSHL,,,, (P <.) 7 3 7.%,, BSSHL, [9], [] BSSHL,,, 3.9%,.%,
6 Chinese Journal of Otology Vol., o.,
7 7,,,.7%, P (6 ) ( ), >. BSSHL 7,,, 7 ; 6, %,,, 3 <. >.,,,,, John Xenellis [],, ** ** ( ),,,,,, [],,,,,,,, [],, ; 3 79,,, ; 6, : ( ),,,, ; ;,, ;, [6],, / ( /,, 93), 6 <. :,,,, **P., BSSHL,,,,, [], BSSHL, Weng,, [],,,, ;, 3,,,, (AA), [3] ( % % %) [],, 6, IgE 3,
Chinese Journal of Otology Vol., o.,, (): 7-9. 6,,,, 9, 3(7): 37-3. 7,,.,,, (): 7-76., ).,,, 6, (): 69. 9 Park HM, Jung SW, Rhee CK. Vestibular diagnosis as prognostic, indicator in sudden hearing loss with vertigo. Acta Otolaryngol, ; Suppl,, : -3.,,,, (6): -. Roman S, Aladio P, Paris J, et al. Prognostic factors of sudden hearing loss in children. Int J Pediatr Otorhinolaryngol,, 6 (): 7-. Weng SF, Chen YS, Hsu CJ, et al. Clinical features of sudden sensorineural Kirikae I, Ishii T, Shidara T, et al. [On types of hearing loss in sudden deafness.] Jibiinkoka, 963, 3: 37-. hearing loss in diabetic patients. Laryngoscope,, (9): 676-6. Yanagita, Murahashi K. Bilateral simultaneous sudden deafness. Arch Otorhinolaryngol, 97, (): 7-.., 9: 7(): 76-77. 3 Fetterman BL, Luxford WM, Saunders JE. Sudden bilateral sensorineural hearing loss. Laryngoscope, 996, 6(): 37-3. Xenellis J, ikolopoulos TP, Stavroulaki P, et al. Simultaneous and sequential bilateral sudden sensorineural hearing loss: are they different from unilateral sudden sensorineural hearing loss. ORL J Otorhinolaryngol Relat Spec, 7, 69(): 36-3. Oh JH, Park K, Lee SJ, et al. Bilateral versus unilateral sudden sensorineural hearing loss. Otolaryngol Head eck Surg, 7, 36,..,.. (,.. 3,.,,..,, 3(): 33-3.,.., 6, (): -3. 6,,,.., 7, (): -. ( :--9),, : ; ; ; 3., : : 3669; : sxzent@63.com