山东大学耳鼻喉眼学报 ›› 2025, Vol. 39 ›› Issue (2): 126-131.doi: 10.6040/j.issn.1673-3770.0.2023.275

• 综述 • 上一篇    

急性低频感音神经性听力下降病因及发病机制的研究进展

潘佳煜,张春林   

  1. 遵义医科大学附属医院 耳鼻咽喉科, 贵州 遵义 563000
  • 发布日期:2025-03-26
  • 通讯作者: E-mail:echo_zcl1314@qq.com

Research advances on the etiology and pathogenesis of acute low-frequency sensorineural hearing loss

PAN Jiayu, ZHANG Chunlin   

  1. Department of Otorhinolaryngology, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou, China
  • Published:2025-03-26

摘要: 急性低频感音神经性听力下降(acute low-frequency sensorineural hearing loss, ALHL)是耳内科常见疾病之一,近年来发病率逐渐增高,发病人群也愈趋于年轻化。ALHL具有临床预后好、高复发、甚至可进展为梅尼埃等特点。截止目前,急性低频感音神经性听力下降的具体病因和发病机制尚未完全明确,可能的病因及发病机制包括:内淋巴积水、免疫学因素、病毒感染、血管循环及血液系统障碍因素、代谢性疾病等。本文针对近年来ALHL的病因和发病机制的研究进展做一综述,提高临床对该疾病的认识,以期及时、有效的作出可靠的诊断。

关键词: 急性低频感音神经性听力下降, 病因, 发病机制, 研究进展

Abstract: Acute low-frequency sensorineural hearing loss(ALHL)is one of the common diseases in otology, and its incidence has been gradually increasing in recent years; the population with ALHL is getting younger and younger. ALHL is characterized by a good clinical prognosis, a high recurrence rate, and even the progression of Meniere's disease. The specific etiology and pathogenesis of ALHL have not been fully clarified till now. The specific etiology and pathogenesis of acute low-frequency sensorineural hearing loss have not been completely clarified, and the possible etiology and pathogenesis include endolymphatic fluid, immunological factors, viral infections, vascular circulatory and hematologic disorders, and metabolic diseases. In this article, we would like to summarize the progress of research on the etiology and pathogenesis of ALHL in recent years, to improve the clinical understanding of this disease, so as to make a reliable diagnosis in a timely and effective manner.

Key words: Acute low-frequency sensorineural hearing loss, Etiology, Pathogenesis, Research progress

中图分类号: 

  • R764
[1] Abe T. Acute sensorineural hearing loss in low frequencies[J]. Otolaryngol(Tokyo), 1982, 54: 385-392. doi:10.11477/mf.1492209443
[2] Chandrasekhar SS, Tsai Do BS, Schwartz SR, et al. Clinical practice guideline: sudden hearing loss(update)[J]. Otolaryngol Head Neck Surg, 2019, 161(1_suppl): S1-S45. doi:10.1177/0194599819859885
[3] 李娟娟, 曾宪海, 魏建芳, 等. 急性低频感音神经性聋临床特征及疗效分析[J]. 中国耳鼻咽喉头颈外科, 2020, 27(7): 407-409. doi:10.16066/j.1672-7002.2020.07.011 LI Juanjuan, ZENG Xianhai, WEI Jianfang, et al. Clinical characteristics and curative effect analysis of acute low-frequency sensorineural deafness[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2020, 27(7): 407-409. doi:10.16066/j.1672-7002.2020.07.011
[4] 吕臻一, 唐旭霞. 急性低频感音神经性听力下降的研究概述[J]. 中华耳科学杂志, 2022, 20(6): 987-992. doi:10.3969/j.issn.1672-2922.2022.06.023 LÜ Zhenyi, TANG Xuxia. An overview of research on acute low-tone sensorineural hearing loss[J]. Chinese Journal of Otology, 2022, 20(6): 987-992. doi:10.3969/j.issn.1672-2922.2022.06.023
[5] 袁佛良, 魏凡钦, 肖志文, 等. 急性低频区感音神经性听力损失临床特征分析[J]. 中华耳科学杂志, 2016, 14(1): 49-52. doi:10.3969/j.issn.1672-2922.2016.01.010 YUAN Foliang,WEI Fanqin,XIAO Zhiwen, et al. Clinical characteristics of acute low-tone sensorineural hearing loss[J]. Chinese Journal of Otology, 2016, 14(1): 49-52. doi:10.3969/j.issn.1672-2922.2016.01.010
[6] 刘岩, 周其友, 侯志强, 等. 急性低频感音神经性听力损失的听力学检查特征及意义[J]. 中华耳科学杂志, 2011, 9(1): 38-42. doi:10.3969/j.issn.1672-2922.2011.01.009 LIU Yan, ZHOU Qiyou, HOU Zhiqiang, et al. Audiometric testing in acute low-tone sensorineural hearing loss[J]. Chinese Journal of Otology, 2011, 9(1): 38-42. doi:10.3969/j.issn.1672-2922.2011.01.009
[7] 叶毅良, 卢标清. 704例突发性耳聋疗效分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 44-47. doi:10.6040/j.issn.1673-3770.0.2019.052 YE Yiliang, LU Biaoqing. Therapeutic outcome analysis of 704 cases of sudden deafness[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(5): 44-47. doi:10.6040/j.issn.1673-3770.0.2019.052
[8] Yamasoba T, Kikuchi S, Sugasawa M, et al. Acute low-tone sensorineural hearing loss without vertigo[J]. Arch Otolaryngol Head Neck Surg, 1994, 120(5): 532-535. doi:10.1001/archotol.1994.01880290042007
[9] Nageris B, Adams JC, Merchant SN. A human temporal bone study of changes in the basilar membrane of the apical turn in endolymphatic hydrops[J]. Am J Otol, 1996, 17(2): 245-252.
[10] 贾贤浩, 梁琴, 池涨才, 等. 豚鼠内淋巴积水早期低频听力损失的形态学变化[J]. 生理学报, 2012, 64(1): 48-54. doi:10.13294/j.aps.2012.01.014 JIA Xianhao, LIANG Qin, CHI Zhangcai, et al. Morphological changes associated with low-tone hearing loss in guinea pig models of early endolymphatic hydrops[J]. Acta Physiologica Sinica, 2012, 64(1): 48-54. doi:10.13294/j.aps.2012.01.014
[11] Kato M, Sugiura M, Shimono M, et al. Endolymphatic hydrops revealed by magnetic resonance imaging in patients with atypical Meniere's disease[J]. Acta Otolaryngol, 2013, 133(2): 123-129. doi:10.3109/00016489.2012.726374
[12] 张瑶瑶,王海涛. 内耳钆造影磁共振成像技术在梅尼埃病诊疗中的应用[J]. 山东大学耳鼻喉眼学报, 2021, 35(6): 101-107. doi:10.6040/j.issn.1673-3770.0.2020.504 ZHANG Yaoyao, WANG Haitao. The application of MRI technology with intratympanic gadolinium injection in the diagnosis and treatment of Meniere's disease[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(6): 101-107. doi:10.6040/j.issn.1673-3770.0.2020.504
[13] Junicho M, Aso S, Fujisaka M, et al. Prognosis of low-tone sudden deafness - does it inevitably progress to Meniere's disease?[J]. Acta Otolaryngol, 2008, 128(3): 304-308. doi:10.1080/00016480601002096
[14] Stölzel K, Droste J, Voß LJ, et al. Comorbid symptoms occurring during acute low-tone hearing loss(AHLH)as potential predictors of menière's disease[J]. Front Neurol, 2018, 9: 884. doi:10.3389/fneur.2018.00884
[15] Yamasoba T, Kikuchi S, Yagi M, et al. Prognosis of acute low-tone sensorineural hearing loss[J]. Nihon Jibiinkoka Gakkai Kaiho, 1992, 95(1): 41-50. doi:10.3950/jibiinkoka.95.41
[16] Inui H, Sakamoto T, Ito T, et al. Magnetic resonance imaging of the endolymphatic space in patients with acute low-tone sensorineural hearing loss[J]. Auris Nasus Larynx, 2019, 46(6): 859-865. doi:10.1016/j.anl.2019.04.003
[17] 任同力, 汪毅, 王武庆. 低频下降型突发性聋内淋巴积水特征分析[J]. 中华医学杂志, 2020, 100(46): 3680-3683. doi:10.3760/cma.j.cn112137-20200928-02741 REN Tongli, WANG Yi, WANG Wuqing. Characteristics of endolymphatic hydrops in low frequency descent sudden hearing loss[J]. National Medical Journal of China, 2020, 100(46): 3680-3683. doi:10.3760/cma.j.cn112137-20200928-02741
[18] 赵丽萍, 范尔钟, 陈秀伍, 等. 低频感音神经性聋患者的内耳免疫学探讨[J]. 中国耳鼻咽喉头颈外科, 2004, 11(4): 253-255. doi:10.3969/j.issn.1672-7002.2004.04.015 ZHAO Liping, FAN Erzhong, CHEN Xiuwu, et al. Inner immune alteration in patient with sen-sorineural deafness in low frequency[J]. Chinese Archives of Otolaryngology-head and Neck Surgery, 2004, 11(4): 253-255. doi:10.3969/j.issn.1672-7002.2004.04.015
[19] 王浩然, 王大勇, 王秋菊. 免疫介导性内耳病的诊断和治疗研究进展[J]. 临床耳鼻咽喉头颈外科杂志, 2020, 34(3): 276-281. doi:10.13201/j.issn.2096-7993.2020.03.023 WANG Haoran, WANG Dayong, WANG Qiuju. Advances in diagnosis and therapies of immune-mediated inner ear diseases[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2020, 34(3): 276-281. doi:10.13201/j.issn.2096-7993.2020.03.023
[20] Chen DY, Wang ZJ, Jia GG, et al. The role of anti-endothelial cell autoantibodies and immune response in acute low-tone hearing loss[J]. Ear Nose Throat J, 2021, 100(3_suppl): 292-300. doi:10.1177/0145561320952501
[21] Das S, Bakshi SS, Seepana R. Demystifying autoimmune inner ear disease[J]. Eur Arch Otorhinolaryngol, 2019, 276(12): 3267-3274. doi:10.1007/s00405-019-05681-5
[22] Fu YY, Zhao H, Gao N, et al. Correlation study of peripheral blood inflammatory factors in patients with sudden deafness[J]. J Clin Otorhinolaryngol Head Neck Surg, 2019, 33(8): 688-691. doi:10.13201/j.issn.1001-1781.2019.08.002
[23] Cadoni G, Fetoni AR, Agostino S, et al. Autoimmunity in sudden sensorineural hearing loss: possible role of anti-endothelial cell autoantibodies[J]. Acta Otolaryngol Suppl, 2002(548): 30-33. doi:10.1080/00016480260094947
[24] Kiakojuri K, Yousef Ghahari B, Soltanparast S, et al. Hearing status in patients with rheumatoid arthritis[J]. Caspian J Intern Med, 2019, 10(4): 447-451. doi:10.22088/cjim.10.4.447
[25] Tsai YT, Chang IJ, Hsu CM, et al. Association between sudden sensorineural hearing loss and preexisting thyroid diseases: a nationwide case-control study[J]. Int J Environ Res Public Health, 2020, 17(3): 834. doi:10.3390/ijerph17030834
[26] Okawa Y, Ihara K. Sensorineural hearing loss in sjögren's syndrome[J]. Int J Mol Sci, 2022, 23(19): 11181. doi:10.3390/ijms231911181
[27] 王汝嬿, 郭明丽, 屈永涛. 梅尼埃病与Ⅰ型变态反应关系的研究进展[J]. 听力学及言语疾病杂志, 2020, 28(2): 221-225. doi:10.3969/j.issn.1006-7299.2020.02.026 WANG Ruyan, GUO Mingli, QU Yongtao. Research progress on the relationship between Meniere's disease and type i allergic reaction[J]. Journal of Audiology and Speech Pathology, 2020, 28(2): 221-225. doi:10.3969/j.issn.1006-7299.2020.02.026
[28] Ma Y, Sun Q, Zhang KL, et al. High level of IgE in acute low-tone sensorineural hearing loss: a predictor for recurrence and Meniere Disease transformation[J]. Am J Otolaryngol, 2021, 42(2): 102856. doi:10.1016/j.amjoto.2020.102856
[29] 张园, 王乐, 李红敏, 等. 炎性细胞因子及淋巴细胞对突发性耳聋的诊断价值研究[J]. 实用医院临床杂志, 2023, 20(4): 50-54. doi:10.3969/j.issn.1672-6170.2023.04.013 ZHANG Yuan, WANG Le, LI Hongmin, et al. Diagnostic value of inflammatory cytokines and lymphocytes in patients with sudden deafness[J]. Practical Journal of Clinical Medicine, 2023, 20(4): 50-54. doi:10.3969/j.issn.1672-6170.2023.04.013
[30] Fuse T, Hayashi T, Oota N, et al. Immunological responses in acute low-tone sensorineural hearing loss and Ménière's disease[J]. Acta Oto Laryngol, 2003, 123(1): 26-31. doi:10.1080/0036554021000028074
[31] Chen KT, Wen LY, Zong L, et al. Audiological outcomes in sudden sensorineural hearing loss with presumed inner ear hemorrhage[J]. Am J Otolaryngol, 2019, 40(2): 274-278. doi:10.1016/j.amjoto.2018.09.017
[32] Nozawa I, Imamura SI, Mizukoshi A, et al. Clinical study of acute low-tone sensorineural hearing loss: survey and analysis of glycerol test and orthostatic test[J]. Ann Otol Rhinol Laryngol, 2002, 111(2): 160-164. doi:10.1177/000348940211100209
[33] Pirodda A, Ferri GG, Modugno GC, et al. Hypotension and sensorineural hearing loss: a possible correlation[J]. Acta Otolaryngol, 1999, 119(7): 758-762. doi:10.1080/00016489950180388
[34] 王香香, 刁明芳. 突发性感音神经性聋病因及发病机制研究进展[J]. 国际耳鼻咽喉头颈外科杂志, 2021(6): 360-363, 367. WANG Xiangxiang, DIAO Mingfang. Advance in the etiology and pathogenesis of sudden sensorineural hearing loss[J]. International Journal of Otolaryngology-Head and Neck Surgery, 2021(6): 360-363, 367.
[35] Przewo zny T, Gasecki D, Narozny W, et al. Risk factors of sensorineural hearing loss in patients with ischemic stroke[J]. Otol Neurotol, 2008, 29(6): 745-750. doi:10.1097/MAO.0b013e318181336c
[36] Abe Y, Toyama K, Kazurayama M, et al. Low-normal platelets and decreasing platelets are risk factors for hearing impairment development[J]. Laryngoscope, 2021, 131(4): E1287-E1295. doi:10.1002/lary.28970
[37] 雷丽红, 丁晓丽, 徐改萍, 等. 突发性耳聋病例特征及危险因素分析[J]. 华南预防医学, 2022, 48(5): 539-542. LEI Lihong, DING Xiaoli, XU Gaiping, et al. Characteristics and risk factors of sudden deafness[J]. South China Journal of Preventive Medicine, 2022, 48(5): 539-542.
[38] Chen X, Fu YY, Zhang TY. Role of viral infection in sudden hearing loss[J]. J Int Med Res, 2019, 47(7): 2865-2872. doi:10.1177/0300060519847860
[39] Park AH. Detecting hearing loss in a child with congenital cytomegalovirus infection-finding the elusive needle in the haystack[J]. JAMA Otolaryngol Head Neck Surg, 2023, 149(2): 131-132. doi:10.1001/jamaoto.2022.4155
[40] Kokten N, Celik S, Mutlu A, et al. Does COVID-19 have an impact on hearing?[J]. Acta Otolaryngol, 2022, 142(1): 48-51. doi:10.1080/00016489.2021.2020897
[41] Kim SY, Kim MK, Lim JS, et al. Migraine increases the proportion of sudden sensorineural hearing loss: a longitudinal follow-up study[J]. Auris Nasus Larynx, 2019, 46(3): 353-359. doi:10.1016/j.anl.2018.10.006
[42] Xue JF, Ma X, Lin YJ, et al. Audiological findings in patients with vestibular migraine and migraine: history of migraine may be a cause of low-tone sudden sensorineural hearing loss[J]. Audiol Neurootol, 2020, 25(4): 209-214. doi:10.1159/000506147
[43] Scinicariello F, Carroll Y, Eichwald J, et al. Association of obesity with hearing impairment in adolescents[J]. Sci Rep, 2019, 9(1): 1877. doi:10.1038/s41598-018-37739-5
[44] Lalwani AK, Katz K, Liu YH, et al. Obesity is associated with sensorineural hearing loss in adolescents[J]. Laryngoscope, 2013, 123(12): 3178-3184. doi:10.1002/lary.24244
[45] 张亚男, 郝玲, 韩梅. 突发性耳聋发病相关危险因素[J]. 中国老年学杂志, 2021, 41(5): 1022-1024. doi:10.3969/j.issn.1005-9202.2021.05.037 ZHANG Yanan, HAO Ling, HAN Mei. Risk factors related to sudden deafness[J]. Chinese Journal of Gerontology, 2021, 41(5): 1022-1024. doi:10.3969/j.issn.1005-9202.2021.05.037
[46] Wattamwar K, Qian ZJ, Otter J, et al. Association of cardiovascular comorbidities with hearing loss in the older old[J]. JAMA Otolaryngol Head Neck Surg, 2018, 144(7): 623-629. doi:10.1001/jamaoto.2018.0643
[47] Zhang YN, Jiang Q, Wu XW, et al. The influence of metabolic syndrome on the prognosis of idiopathic sudden sensorineural hearing loss[J]. and, 2019, 40(8): 994-997. doi:10.1097/MAO.0000000000002352
[48] Zhou YL, Qiu SY, Liu DB. Impact of metabolic syndrome on recovery of idiopathic sudden sensorineural hearing loss[J]. Am J Otolaryngol, 2019, 40(4): 573-576. doi:10.1016/j.amjoto.2019.05.011
[49] 陈磊, 王英俊, 孙晓, 等. 低频下降型突发性聋预后相关因素分析[J]. 中华耳鼻咽喉头颈外科杂志, 2020, 55(7): 652-657. doi:10.3760/cma.j.cn115330-20191212-00756 CHEN Lei, WANG Yingjun, SUN Xiao, et al. Analysis of prognostic factors of low-frequency type of sudden sensorineural hearing loss[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery,2020, 55(7): 652-657. doi:10.3760/cma.j.cn115330-20191212-00756
[1] 吴玮,王磊,陈升,李连勇,王刚. 胃食管气道反流性疾病多学科研究及进展[J]. 山东大学耳鼻喉眼学报, 2024, 38(6): 1-14.
[2] 彭宇婷,李坚昊,王燕. 鼻-眼眶-颅底恶性肿瘤继发眶尖综合征1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2024, 38(5): 105-111.
[3] 胡婷婷,王越华. 阻塞性睡眠呼吸暂停与乳腺癌相关性研究进展[J]. 山东大学耳鼻喉眼学报, 2023, 37(6): 41-45.
[4] 金婧, 冷辉. SARS-CoV-2感染后嗅觉功能障碍治疗的研究进展[J]. 山东大学耳鼻喉眼学报, 2023, 37(5): 162-174.
[5] 陈倬诣,郑亿庆,杨海弟. 慢性主观性耳鸣分类、发生发展机制及治疗新进展[J]. 山东大学耳鼻喉眼学报, 2023, 37(4): 1-12.
[6] 张红,李欣. 中枢神经系统活动异常在耳鸣发生中的作用与机制[J]. 山东大学耳鼻喉眼学报, 2023, 37(4): 24-29.
[7] 李璐,赵杰,赵博军. 中心性浆液性脉络膜视网膜病变的发病机制与治疗研究进展[J]. 山东大学耳鼻喉眼学报, 2023, 37(3): 118-124.
[8] 王娇娇,李苗宋宗明. 糖尿病视网膜病变的机制和细胞模型研究进展[J]. 山东大学耳鼻喉眼学报, 2022, 36(5): 93-99.
[9] 王兴鑫,杨欣雨,郑晓军,丁麟,盛亚文,毕晓云,杨继国. 穴位贴敷疗法治疗小儿腺样体肥大1例[J]. 山东大学耳鼻喉眼学报, 2022, 36(5): 122-124.
[10] 林海,朱莹,张维天. 慢性鼻窦炎发病中离子通道作用研究进展[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 64-70.
[11] 李佳倪,朱冬冬,孟粹达. 表观遗传学在慢性鼻窦炎伴鼻息肉发病机制中的作用[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 84-91.
[12] 韩莹莹,李延忠. 阻塞性睡眠呼吸暂停低通气综合征与亚临床动脉粥样硬化[J]. 山东大学耳鼻喉眼学报, 2022, 36(2): 126-132.
[13] 王宇婷,王嘉玺. microRNA在过敏性鼻炎发病机制中的研究进展[J]. 山东大学耳鼻喉眼学报, 2021, 35(5): 98-104.
[14] 向浏岚,叶远航,蒋璐云,刘洋. Tim-3在变应性鼻炎中的作用及机制研究进展[J]. 山东大学耳鼻喉眼学报, 2020, 34(6): 118-122.
[15] 朱正茹,张小兵. 高迁移率族蛋白B1与变应性鼻炎的相关性[J]. 山东大学耳鼻喉眼学报, 2020, 34(6): 123-128.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!