CAJ | 학술논문

目的分析突发性听力减退为首发症状的听神经瘤的临床特点，以避免对该病的误诊、误治。方法对1983～1997年收治听神经瘤92例中20例（21耳）首发症状为突发性听力减退的病例（占21.7%）进行回顾性分析。结果听力学检测：纯音听阈（500 Hz、1 000 Hz、2 000 Hz听力平均听阈）＞71 dB HL者12耳，占57.1%；听性脑干反应（auditory brainstem response, ABR）检测均有异常；声反射检测9例（10耳）均消失。影像学检查CT阳性率为88.89% ，阴性者行CT气脑造影或磁共振成像（magnetic resonance imaging ,MRI）检查均能确诊。结论对突发性听力减退可疑听神经瘤的患者应常规检查ABR ，出现异常者应进行颞骨CT，必要时行MRI检查。
목적분석돌발성은력감퇴위수발증상적은신경류적림상특점，이피면대해병적오진、오치。방법대1983～1997년수치은신경류92례중20례（21이）수발증상위돌발성은력감퇴적병례（점21.7%）진행회고성분석。결과은역학검측：순음은역（500 Hz、1 000 Hz、2 000 Hz은력평균은역）＞71 dB HL자12이，점57.1%；은성뇌간반응（auditory brainstem response, ABR）검측균유이상；성반사검측9례（10이）균소실。영상학검사CT양성솔위88.89% ，음성자행CT기뇌조영혹자공진성상（magnetic resonance imaging ,MRI）검사균능학진。결론대돌발성은력감퇴가의은신경류적환자응상규검사ABR ，출현이상자응진행섭골CT，필요시행MRI검사。
Objective　To avoid misdiagnosis and misapplied therapy of acoustic neuroma. Methods　92 cases of acoustic neuroma treated between 1983 and 1997 were retrospectively reviewed. Among them, 20 patients (21 ears, 21.7%) presented with sudden hearing loss as the starting symptoms. The diagnosis was based on audiological and radiologic examinations. Results　The clinical and audiological analysis demonstrated that 57.1% of the ears showed hearing loss over 71 dBHL, and all ears had deteriorated ABRs. Acoustic reflex was nonreactive in all 10 ears tested. Positive findings in CT scan were 88.89%. CT pneumoencephalography or MRI provided useful information of diagnosis in those with negative findings of plane CT scan. Conclusion　ABR should be used as a routine test for patients with sudden deafness. When ABR was abnormal, CT scan around the internal auditory meatus was needed.