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目的探讨大前庭水管综合征与职业性噪声聋的鉴别诊断。方法对1例疑似职业性噪声聋病例的体检结果资料进行综合分析。结果患者间断接触非稳态噪声26年,8h工作制,发病前半年因生产任务紧,每天需超过12h停留在罐体长度不超过2.5 m、内径不超过1.5 m的狭窄空间工作。工作过程中半年之内相继出现双耳听力重度下降,双侧颞骨CT平扫提示:大前庭水管综合征。诊断结果双耳非职业性听力损伤,大前庭水管综合征(LVAS)。结论建议今后在职业性噪声聋鉴别诊断中,尤其在语言频段听力损失超过中度噪声聋以上时,应常规作颞骨CT检查以排除先天性内耳畸形致聋。随着颞骨影像学检查的不断完善和发展,CT、MRI等检查手段也应及时应用于职业健康监护工作中,以排除先天性内耳发育畸形,及时发现潜在的噪声作业职业禁忌证。
Objective To investigate the differential diagnosis of large vestibular aqueduct syndrome and occupational noise deafness. Methods A case of suspected occupational noise and deaf cases of physical examination results were analyzed. Results The patients were exposed to unsteady noise for 26 years and 8 hours, and the work schedule was tight in the first half of the first half of the year due to the tight production schedule. The daily work required more than 12 hours and stayed in a confined space with a tank length of no more than 2.5 m and an inner diameter of no more than 1.5 m. Half a year in the course of work have severe hearing loss of both ears, bilateral temporal CT scan prompts: large vestibular aqueduct syndrome. Diagnostic outcomes Non-occupational hearing loss in both ears, large vestibular aqueduct syndrome (LVAS). Conclusion It is suggested that in the future in the differential diagnosis of occupational noise deafness, especially when the hearing loss of the speech frequency band exceeds the moderate noise deafness, the temporal bone CT examination should be routinely performed to exclude the deafness of congenital inner ear deformity. With the continuous improvement and development of the temporal bone imaging examination, examination methods such as CT and MRI should also be promptly applied to occupational health monitoring work to rule out congenital malformations in the inner ear, and to timely find potential occupational contraindications of noise work.