山东大学耳鼻喉眼学报 ›› 2019, Vol. 33 ›› Issue (4): 47-51.doi: 10.6040/j.issn.1673-3770.0.2018.573

• 论著 • 上一篇    下一篇

单侧突发性聋与椎基底动脉影像学特征的相关性研究

赵俊英,王建明   

  1. 山西医科大学第一医院耳鼻咽喉头颈外科, 山西 太原 030001
  • 出版日期:2019-07-20 发布日期:2019-07-22

Correlation between unilateral sudden deafness and imaging features of vertebrobasilar artery

ZHAO Junying, WANG Jianming   

  1. Department of Otorhinolaryngology Head Neck Surgery, The First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China
  • Online:2019-07-20 Published:2019-07-22

PDF (PC)

290

摘要： 目的 探讨单侧突发性聋(简称突聋)与椎基底动脉影像学特征间的关系。 方法 收集2014-2018年在山西医科大学第一医院被诊断为单耳突聋,且临床检验及影像学资料完整的患者175例,分析其听力损失侧别及程度与椎动脉、基底动脉特点间的关系。 结果 椎动脉(χ2=8.031,P=0.045)及基底动脉(χ2=5.091,P=0.034)狭窄/弯曲与听力损失侧别有关。听力损失预测因素的单变量分析结果显示,左侧听力损失患者与右侧(OR=2.89,95%CI为1.77~2.77,P=0.036)及双侧椎动脉狭窄/迂曲(OR=4.43,95%CI为1.49~13.23,P=0.008)有关,无基底动脉狭窄/迂曲与右侧听力损失(OR=0.31,95%CI为0.11~0.90,P=0.030)相关,其他因素无统计学意义。年龄和性别匹配的多变量分析结果显示,右侧椎动脉狭窄/迂曲与左耳听力损失有关(OR=2.83,95%CI为1.05~7.67,P=0.040)。患者基底动脉狭窄/迂曲与否与听力损失程度不存在统计学差异(χ2=3.339,P=0.068)。突聋患者听力损失的程度与椎动脉(χ2=3.897,P=0.273)及基底动脉(χ2=3.339,P=0.068)的影像学特征无关。 结论 在突聋患者中,听力损失的侧向性与椎基底动脉是否狭窄/迂曲有关,右侧椎动脉狭窄/迂曲与左耳听力损失有关。

关键词: 突发性聋, 椎基底动脉, 后循环缺血, 病因

Abstract: Objective To investigate the correlation between unilateral sudden deafness and the imaging features of vertebrobasilar artery. Methods This study included 175 patients diagnosed with unilateral sudden deafness in our hospital between 2014 and 2018, who had complete laboratory and imaging data. Data were analyzed in order to determine the relationship between the side and degree of hearing loss and the imaging characteristics of vertebral and basilar arteries. Results A stenosis/tortuosity of vertebral(χ2=8.031, P=0.045)and basilar arteries(χ2=5.091, P=0.034)was found to be related to hearing loss side. The univariate analysis results of hearing loss predictors demonstrated that left-sided hearing loss in patients is related to right-sided(odds ratio ［OR］=2.89, 95% confidence interval ［CI］: 1.77-2.77, P=0.036)and bilateral vertebral artery stenosis/tortuosity(OR=4.43, 95% CI: 1.49-13.23, P=0.008). Basilar artery stenosis/tortuosity on neither side is related to right-sided hearing loss in patients(OR=0.31, 95% CI: 0.11-0.90, P=0.030). Other evaluated factors were not statistically significant. Multivariate analysis matched by age and sex demonstrated that stenosis/tortuosity of the right vertebral artery was related to left-sided hearing loss(OR=2.83, 95% CI: 1.05-7.67, P=0.040), whereas no statistically significant difference was observed for the relationship between stenosis/tortuosity of basilar artery and hearing loss(χ2 = 3.339, P=0.068). The degree of hearing loss in patients with sudden deafness is not related with the imaging features of the vertebral(χ2 = 3.897, P=0.273)and basilar arteries(χ2 = 3.339, P=0.068). Conclusion In patients with sudden deafness, the lateral nature of hearing loss is influenced by stenosis/tortuosity of the vertebrobasilar artery, whereas stenosis/tortuosity of the right vertebral artery is related to hearing loss in the left ear.

Key words: Sudden deafness, Vertebrobasilar artery, Posterior circulation ischemia, Etiology

中图分类号: 

  • R764.13
[1] 中华耳鼻咽喉头颈外科杂志编辑委员会[J]. 中华医学会耳鼻咽喉头颈外科学分会. 突发性聋诊断和治疗指南(2015)[J]. 2015, 50(6): 443-447. doi:10.3760/cma.j.issn.1673-0860.2015.06.002.
[2] Wei BP, Stathopoulos D, O'Leary S. Steroids for idiopathic sudden sensorineural hearing loss. Jama the Journal of the American Medical Association, 2011, 305(20): 2114-5. doi:10.1002/14651858.cd003998.pub2.
[3] Kim C, Sohn JH, Choi HC. Vertebrobasilar angulation and its association with sudden sensorineural hearing loss[J]. Medical Hypotheses, 2012, 79(2): 202-203. doi:10.1016/j.mehy.2012.04.035.
[4] Kim C, Sohn JH, Jang MU, et al. Ischemia as a potential etiologic factor in idiopathic unilateral sudden sensorineural hearing loss: Analysis of posterior circulation arteries[J]. Hearing Research, 2016, 331: 144-151. doi:10.1016/j.heares.2015.09.003.
[5] Lin C, Lin SW, Lin YS, et al. Sudden sensorineural hearing loss is correlated with an increased risk of acute myocardial infarction: A population-based cohort study[J]. Laryngoscope, 2013, 123(9):2254-2258. doi: 10.1002/lary.23837.
[6] Lee H. Recent advances in acute hearing loss due to posterior circulation ischemic stroke[J]. Journal of the Neurological Sciences, 2014, 338(1/2): 23-29. doi:10.1016/j.jns.2013.12.048.
[7] 艾伟, 孔维佳. 氧自由基对豚鼠耳蜗微血管内皮细胞凋亡的影响及其机制[J]. 华中科技大学学报(医学版), 2009, 38(3): 359-363. doi:10.3870/j.issn.1672-0741.2009.03.019. AI Wei, KONG Weijia. Effects of oxygen free radical on apoptosis in cochlea microvascular endothelial cells of guinea pigs and the underlying mechanism[J]. Acta Medicinae Universitatis Science of Technologiae Huazhong, 2009, 38(3): 359-363. doi:10.3870/j.issn.1672-0741.2009.03.019.
[8] Lee H. Neuro-otological aspects of cerebellar stroke syndrome[J]. J Clin Neurol, 2009, 5(2): 65. doi:10.3988/jcn.2009.5.2.65.
[9] 翁秋燕, 胡兴越. 后循环缺血的临床及影像学特点探讨[J]. 中华临床医师杂志(电子版), 2010, 4(9): 1717-1719. doi:10.3969/cma.j.issn.1674-0785.2010.09.070.
[10] Hong JM, Chung CS, Bang OY, et al. Vertebral artery dominance contributes to basilar artery curvature and peri-vertebrobasilar junctional infarcts[J]. Journal of Neurology, Neurosurgery & Psychiatry, 2009, 80(10): 1087-1092. doi:10.1136/jnnp.2008.169805.
[11] Chuang YM, Chern CM, Liao WH, et al. Contribution of intracranial vertebral artery asymmetry to vestibular neuropathy[J]. Journal of Neurology, Neurosurgery & Psychiatry, 2011, 82(7): 823-825. doi:10.1136/jnnp.2009.203323.
[12] Dai Y, Lu L, Hou J, et al. Intratympanic methylprednisolone perfusion as a salvage treatment for profound idiopathic sudden sensorineural hearing loss[J]. J Laryngol Otol, 2017, 131(5): 404-410. doi:10.1017/s0022215117000548.
[13] Hsu YH, Hu HY, Chiu YC, et al. Association of sudden sensorineural hearing loss with vertebrobasilar insufficiency[J]. JAMA Otolaryngol Head Neck Surg, 2016, 142(7): 672. doi:10.1001/jamaoto.2016.0845.
[14] Ryu OH, Choi MG, Park CH, et al. Hyperglycemia as a potential prognostic factor of idiopathic sudden sensorineural hearing loss[J]. Otolaryngol Head Neck Surg, 2014, 150(5):853-858. doi: 10.1177/0194599814521012.
[15] Lee H, Baloh RW. Sudden deafness in vertebrobasilar ischemia: clinical features, vascular topographical patterns and long-term outcome[J]. Journal of the Neurological Sciences, 2005, 228(1): 99-104. doi:10.1016/j.jns.2004.10.016.
[16] Quaranta N, Squeo V, Sangineto M, et al. High total cholesterol in peripheral blood correlates with poorer hearing recovery in idiopathic sudden sensorineural hearing loss[J]. PLoS One, 2015, 10(7): e0133300. doi:10.1371/journal.pone.0133300.
[17] Hademenos GJ, Massoud TF. Biophysical mechanisms of stroke[J]. Stroke, 1997, 28(10): 2067-2077. doi:10.1161/01.str.28.10.2067.
[18] 陈伟, 胡中南, 童钊君, 等. 青中年无眩晕、心脑血管疾病病史的突发性聋患者高刺激率听性脑干反应特征分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 45-49. doi:10.6040/j.issn.1673-3770.0.2017.521. CHEN Wei, HU Zhongnan, TONG Zhaojun, et al. Characteristics of auditory brainstem response to high-frequency stimulus in young and middle-aged patients with sudden deafness and no history of vertigo or cardiocerebrovascular disease[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(5): 45-49. doi:10.6040/j.issn.1673-3770.0.2017.521.
[1] 申宇鹏,宋琦,李晓明. 喉癌前病变的病因、分子机制和处理策略[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 25-30.
[2] 钟晓声,杨海弟,郑亿庆. 突发性聋伴耳鸣的治疗与转归[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 43-46.
[3] 张俊军,刘海莉,刘加福,秦小奉,杜洪明,王厚慧. 糖皮质激素不同给药方式治疗突发性聋的临床疗效及安全性研究[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 52-55.
[4] 童巧珍,赵艳,程四华. 突发性聋患者负性情绪知信行模式构建及应用效果[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 162-164.
[5] 王玥,刘芊,王海波. 自发性脑脊液耳漏的研究进展[J]. 山东大学耳鼻喉眼学报, 2019, 33(2): 130-135.
[6] 孙子雯,崔洪玮,孙喜灵,陈晨,张璐,胡竹林. 干眼病的病因、发病机制及治疗进展[J]. 山东大学耳鼻喉眼学报, 2019, 33(2): 159-166.
[7] 郝创利,顾文婧. 认识不同年龄儿童慢性咳嗽的病因[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 20-24.
[8] 许明,罗兴谷,唐洪波,江青山. 儿童突发性聋的临床特征及预后相关因素分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 41-44.
[9] 陈伟,胡中南,童钊君,李湘宇,刘文君. 青中年无眩晕、心脑血管疾病病史的突发性聋患者高刺激率听性脑干反应特征分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 45-49.
[10] 朱文燕,金新,佘万东,马永驰. 突发性聋30例精神心理状况分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 50-52.
[11] 鄢慧琴,王豪. 难治性良性阵发性位置性眩晕的临床分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 86-88.
[12] 张玉波,岳丽艳,尹晓妍,吕哲,单春光. 耳鸣治疗仪联合银杏叶提取物注射液治疗突聋伴耳鸣的疗效分析[J]. 山东大学耳鼻喉眼学报, 2017, 31(5): 50-53.
[13] 王旭川,盛艳娟,王玉. 非外伤性玻璃体积血的病因及手术疗效分析[J]. 山东大学耳鼻喉眼学报, 2017, 31(1): 107-109.
[14] 刘阳云,张彩霞,江文,陈琼,常恩格,赵花香,杨会. 突发性聋患者血脂分析[J]. 山东大学耳鼻喉眼学报, 2016, 30(6): 1-4.
[15] 朱江彬,南兵卫,陈涛, 郝宗生. 低中频下降型突发性聋听阈恢复后残留耳鸣治疗体会[J]. 山东大学耳鼻喉眼学报, 2016, 30(6): 5-7.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] 邓基波,孙奉乾,许安廷 . 大前庭导水管综合征[J]. 山东大学耳鼻喉眼学报, 2006, 20(2): 116 -118 .
[2] 周子宁,金国威 . 喉气管狭窄的预防和治疗进展[J]. 山东大学耳鼻喉眼学报, 2006, 20(5): 462 -465 .
[3] 周斌,李滨 . 鼻内窥镜下鼻窦鼻息肉手术75例疗效观察[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 24 -26 .
[4] 徐赛男,杨雷 . 红霉素促进鼻息肉上皮细胞凋亡的实验研究[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 27 -29 .
[5] 谢治年 综述,姬长友 审校 . RNA干扰及其在喉鳞癌研究中的应用[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 200 -203 .
[6] 汪晓锋,林 昶,程金妹 . 不同龄小鼠内耳中ABAD的表达及临床意义[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 207 -211 .
[7] 凡启军,黄治物,梅 玲,肖伯奎 . 荧光定量PCR测定水杨酸钠作用后大鼠耳蜗基因的表达[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 212 -214 .
[8] 杨淑娟,袁 英,刘付星,秦海平 . 美宝湿润烧伤膏联合蛋膜贴补治疗外伤性鼓膜穿孔40例[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 227 -227 .
[9] 林峰,梁勇,卢永田,万丽霞 . 鼻内翻性乳头状瘤临床分型和术式选择[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 231 -233 .
[10] 庞太忠,刘冰,程良军 . 鼻中隔偏曲矫正术治疗变应性鼻炎[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 237 -238 .
网站版权所有 © 2018 《山东大学耳鼻喉眼学报》编辑部　
地址：山东省济南市山大南路27号（250100）电话：+86-0531-88366912 E-mail: ebhxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发