突发性耳聋(简称突聋),是指72h内突然发生的、原因不明的感音神经性听力损失,通常在数分钟、数小时或一天内患者听力下降至最低点(少部分第3天降至最低点),至少在相邻的两个频率听力下降≥20dBHL,同时可伴有耳鸣或眩晕,部分患者有自愈倾向。
Suddendeafness(SD)referstothesuddenandunexplainedsensorineuralhearinglosswithin72h,hearinglossusuallyreachesitslowestpointwithinminutes,hours,oraday(afewonday3),hearinglossinatleasttwoadjacentfrequenciesisgreaterthan20dBHL,beingassociatedwithtinnitusorvertigoatthesametime,somepatientsarepronetoselfheal.
一、发病机制及临床表现
I.Pathogenesisandclinicalmanifestations
突发性耳聋的病因和病理生理机制尚未完全阐明,局部因素和全身因素均可引起耳聋,常见的病因包括:血管性疾病、病毒感染、自身免疫性疾病、传染性疾病、肿瘤等。一般认为,过度疲劳、精神紧张、压力大、情绪波动、生活不规律、睡眠障碍、季节性因素等可能是突聋的主要诱因。
Theetiologyandpathophysiologicalmechanismofsuddendeafnesshavenotbeenfullyelucidated.Bothlocalandsystemicfactorscancausedeafness.Commonetiologiesincludevasculardisease,viralinfection,autoimmunedisease,infectiousdisease,tumor,etc.Itisgenerallybelievedthatexcessivefatigue,mentaltension,greatpressure,moodfluctuations,irregularlife,sleepdisorders,seasonalfactorsmaybethemaininducementofsuddendeafness.
目前较公认的可能发病机制包括:内耳血管痉挛、血管纹功能障碍、血管栓塞或血栓形成、膜迷路积水以及毛细胞损伤等。
Atpresent,themostrecognizedmechanismsincludevasospasmintheinnerear,striataldysfunction,vascularembolismorthrombosis,hydropsofthelabyrinthus,andhaircellinjury.
突发性耳聋的主要临床表现有以下4点:
Themainclinicalmanifestationsofsuddendeafnessincludethefollowingfourpoints:
1.耳聋:多为单侧耳聋,发病前多无先兆,少数患者则先有轻度感冒、疲劳或情绪激动史。
1.Deafness:mostpatientshaveunilateraldeafnesswithnowarningbeforeonset,andafewpatientshaveahistoryofmildcold,fatigueoremotionalexcitementfirst.
耳聋发生突然,患者的听力一般在数分钟或数小时内下降至最低点,少数患者可在3天以内听力损失方达到最低点。
Deafnesshappenssuddenly,thehearingofthepatientfallstonadirinafewminutesorafewhours
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