山东大学耳鼻喉眼学报 ›› 2019, Vol. 33 ›› Issue (5): 48-51.doi: 10.6040/j.issn.1673-3770.0.2018.536

• 论著 • 上一篇    下一篇

人工耳蜗植入术治疗大前庭水管综合征16例临床分析

孙凯丽,吴晓媛(),别旭(),孙秀珍   

  1. 大连医科大学附属第二医院耳鼻咽喉科,辽宁 大连 116027
  • 收稿日期:2018-11-20 修回日期:2019-04-03 出版日期:2019-09-20 发布日期:2019-10-15
  • 通讯作者: 吴晓媛,别旭 E-mail:1084721952@qq.com;bx5581@sina.com
  • 基金资助:
    国家自然科学基金面上项目(11472074);国家自然科学基金青年基金项目(31500764)

Clinical analysis of cochlear implants in 16 patients with large vestibular aqueduct syndrome

Kaili SUN,Xiaoyuan WU(),Xu BIE(),Xiuzhen SUN   

  1. Department of Otorhinolaryngology, Second Hospital of Dalian Medical University, Dalian 116027, Liaoning, China
  • Received:2018-11-20 Revised:2019-04-03 Online:2019-09-20 Published:2019-10-15
  • Contact: Xiaoyuan WU,Xu BIE E-mail:1084721952@qq.com;bx5581@sina.com

摘要: 目的

探讨大前庭水管综合征(LVAS)的发病机制、听力学检查、防治措施。

方法

回顾分析2012~2017年经颞骨高分辨率CT(HRCT)及听力学检查确诊并于大连医科大学附属第二医院行人工耳蜗植入术(CI)的16例 LVAS患者的临床资料,包括发病诱因、确诊及手术情况、CI术前听力情况、语前及语后聋情况。

结果

16例均行HRCT检查,其中语前聋11例,2例有家族遗传史。13例行内耳及颅脑MRI检查,9例行声导抗检查,6例行耳声发射检查,15例行听性脑干反应、多频稳态电位检查,6例行纯音听阈测定检查。16例(32耳)中仅1耳为中重度感音神经性聋、1耳为重度感音神经性聋,余均为极重度感音神经性聋。16例均行CI,术后仅1例出现头晕、1例出现面瘫等并发症。

结论

LVAS主要以进行性、波动性听力下降为特点,为常染色体隐性遗传,早期经HRCT、听力学检查可确诊。目前LVAS最主要的防治措施为产前及产后耳聋基因筛查及CI治疗。

关键词: 大前庭水管综合征, 听力学检查, 耳蜗植入

Abstract: Objective

To study the pathogenesis, audiometry, and the current preventive and treatment measures of large vestibular aqueduct syndrome (LVAS).

Methods

A retrospective analysis was performed on the clinical data of 16 cases (32 ears) from 2012 to 2017 that underwent temporal bone high-resolution computed tomography (HRCT), audiology, and cochlear implantation (CI) at Second Affiliated Hospital of Dalian Medical University for LVAS (predisposing factors, diagnosis, surgical cases, preimplantation audiological examination, and prelingual and post-language deafness).

Results

Among the 16 patients who underwent HRCT, 11 had prelingual deafness, 2 had a family history of genetic diseases, 13 also underwent an MRI of the inner ear and brain, 9 underwent acoustic impedance tests, 6 underwent the otoacoustic emission tests, 15 underwent auditory brainstem response and audio steady-state response tests, and 6 underwent pure tone audiometry. Of the 32 ears, 1 had moderate-to-severe acoustic deafness, 1 had severe acoustic deafness, and the remaining had severe sensorineural hearing loss. The patients were treated with CI, following which 1 had dizziness, and 1 had facial paralysis.

Conclusion

LVAS with progressive, fluctuating hearing loss has an autosomal recessive inheritance. Early diagnosis can be made using HRCT and audiological examination. The preventive and treatment measures of LVAS currently include genetic screening for prenatal and postnatal deafness and CI.

Key words: Large vestibular aqueduct syndrome, Audiology, Cochlear implantation

中图分类号: 

  • R764.431
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