摘要
目的 分析听神经瘤患者听力学特征,为筛查听神经瘤提供参考依据。方法 回顾性分析2019年8月—2022年4月诊治的397例单侧听神经瘤患者临床资料,所有患者均行纯音测听、声导抗测试、言语识别率(SDS)、畸变产物耳声发射(DPOAE)、听性脑干诱发电位(ABR)和颅脑增强MRI。结果 以典型症状就诊者312例,非典型症状就诊者85例。以突发性聋就诊者25例;患耳听力正常者54例,包含大型甚至特大型肿瘤,99例全聋者亦包含内听道和中型肿瘤。5例全聋者言语识别能力未完全消失。DPOAE一致型245例,耳蜗型72例,蜗后型79例。ABR阳性率98.0%(389/397),8例ABR波形正常者中3例为双侧非对称听力损失。结论 非典型症状就诊者占比21.4%,以突发性聋就诊、听力正常或ABR正常者不能排除听神经瘤;DPOAE和ABR可作为筛查听神经瘤的重要检查方法。
Objective To analyze the audiological characteristics of acoustic neuroma(AN)patients,so as to provide reference for AN screening.Methods Clinical data of 397 patients with unilateral AN admitted to our department from August 2019 to April 2022 were retrospectively analyzed.All patients underwent pure tone audiometry(PTA),acoustic immittance,speech discrimination score(SDS),distortion product otoacoustic emission(DPOAE),auditory brainstem response(ABR)and cranial enhanced magnetic resonance imaging(MRI).Results There were 312 patients with typical symptoms and 85 with atypical presentations.Patients with sudden sensorineural hearing loss(n=25)accounted for 6.3%.Fifty-four cases with normal hearing had large or superlarge tumors,and 99 patients with total hearing loss had tumors of the internal auditory canal or medium size.The speech recognition ability of 5 cases with total hearing loss did not disappear completely.There were 245 cases of compatibal type of DPOAE,including cochlear type in 72 cases and retrocochlear type in 79.The sensitivity of ABR was 98.0%(389/397),and 3 of the 8 patients with normal ABR waveform had asymmetric hearing loss.Conclusions Patients with atypical presentations account for 21.4%of AN.AN can not be excluded in patients with sudden hearing loss,normal hearing,and normal ABR.DPOAE and ABR can be used as important methods for screening AN.
作者
郭翠翠
王现蕾
夏寅
GUO Cuicui;WANG Xianlei;XIA Yin(Department of Otorhinolaryngology Head and Neck Surgery,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)
出处
《中国耳鼻咽喉颅底外科杂志》
CAS
CSCD
2024年第2期72-76,共5页
Chinese Journal of Otorhinolaryngology-skull Base Surgery
关键词
听神经瘤
听力
诱发电位
听觉
脑干
Acoustic neuroma
Hearing
Evoked potentials
Auditory sense
Brain stem
