儿童突发性感音神经性听力损失:诊断、治疗和预后的综述

Vít Kruntorád, M. Urík, S. Šikolová
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引用次数: 1

摘要

简介:突发性感音神经性听力损失(SSHL)是儿童的一种急性病。治疗和诊断的通用指南尚未确定。使用客观的诊断方法验证听力阈值水平是必要的。标准化的随访护理对听力障碍的适当矫正至关重要。方法和材料:本回顾性研究分析了2016年至2019年在三级中心住院的14例SSHL患者。比较年龄、性别、患侧、听阈水平、症状、病因及治疗。听力损失按照世界卫生组织的方法进行分类。采用西格尔标准评估回收率。结果:所有儿童均静脉注射初始剂量为5mg /kg/天的甲基强的松龙。本组6例患者(43%)完全康复。左侧SSHL的治疗失败率为75%,右侧SSHL为16.7%。有耳鸣的患者听力恢复的几率为54.5%,而没有耳鸣的患者听力恢复的几率为35.3%。5-10岁、10-15岁和15-18岁儿童治疗失败的风险分别为33%、83%和20%。我们没有观察到其他分析参数对听力恢复有任何影响。结论:耳鸣患儿、右侧受累侧患儿、初始听力损失严重程度较高患儿听力恢复较好。在10-15岁时,听力恢复的机会比其他年龄组低三倍。【关键词】突发性感音神经性听力损失;儿童;听力障碍矫正
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Sudden sensorineural hearing loss in children: a review of dia­gnosis, treatment, and prognosis
Introduction: Sudden sensorineural hearing loss (SSHL) is an acute condition in children. Universal guidelines for treatment and dia­gnosis are not defined. Use of objective dia­gnostic methods in hearing threshold level verification is necessary. Standardized follow-up care is essential for adequate correction of hearing impairment. Methods and material: This retrospective study analysed 14 patients suffering from SSHL, hospitalized between 2016 and 2019 in a tertiary centre. Age, gender, affected side, hearing threshold level, symptoms, cause and treatment were compared. Hearing loss was classified according to the WHO methodology. The recovery rate was assessed by Siegel’s criteria. Results: All children were treated with an initial dose of 5 mg/kg/day of methylprednisolone intravenously. A complete recovery in our group was achieved in 6 cases (43%). The rate of treatment failure was 75% for the left side and 16.7% for right side SSHL. Patients with the presence of tinnitus have a 54.5% chance of hearing restitution, as compared to 35.3% in patients without tinnitus. The risk of treatment failure for children aged 5–10 years, 10–15 years and 15–18 years is 33%, 83% and 20% respectively. We did not observe any effect on hearing recovery for the other analysed parameters. Conclusions: Better hearing recovery was observed in children with tinnitus, the right affected side and a higher severity of initial hearing loss. At the age of 10–15 years, the chance of hearing recovery was three times lower than in other age groups. Key words sudden sensorineural hearing loss – children – correction of hearing impairment
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