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

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2=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.
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