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目的:研究急性低频下降型感音神经性听力损失(ALHL)的病因、诊断和治疗方法。方法:选择55例ALHL患者为研究对象,经详细询问病史和耳专科检查后,行纯音测听,声导抗测听和听性脑干反应(ABR),随机分为泼尼松组和对照组治疗,疗程结束后随访6个月。结果:两组患者多以青年为主,主要症状为耳闷,低音调耳鸣和听力减退,耳科检查无殊。所有患者(55例58耳)纯音听阈示轻到中度低频感音神经性聋,鼓室导抗图“A”型,49耳镫骨肌反射引出,其中40耳Metz试验阳性。受检的45耳中ABR均正常。治疗后泼尼松组效果优于对照组(P<0.05)。结论:ALHL以突发的低音调耳鸣,听力减退和耳闷为主要表现,常单耳发病,听力学定位诊断提示为蜗性病变,仅累及低频区。本病对皮质类固醇激素有一定的治疗效果。
Objective: To study the etiology, diagnosis and treatment of acute low frequency descending sensorineural hearing loss (ALHL). Methods: A total of 55 patients with ALHL were selected as study subjects. After detailed history and ear specialist examination, pure tone audiometry, acoustic impedance audiometry and auditory brainstem response (ABR) were randomly divided into prednisone group and control group Group therapy, after the end of treatment for 6 months. Results: Two groups of patients mostly young, the main symptoms of the ear boredom, low pitched tinnitus and hearing loss, ear examination no special. All patients (55 ears) were pure tone audiometry, mild to moderate low frequency sensory nerve deafness, tympanogram “A”, and 49 ears. The Metz test was positive in 40 ears. ABRs were normal in 45 ears examined. The effect of prednisone group was better than that of control group after treatment (P <0.05). CONCLUSIONS: ALHL is characterized by sudden low pitched tinnitus, hypoallergenicness and lightening of the ears. It is often associated with mononeuropathy. Diagnosis of audiological localization suggests cochlear lesions, involving only the low frequency region. The disease of corticosteroids have a certain therapeutic effect.