本文關(guān)鍵詞：聽神經(jīng)瘤的耳科表現(xiàn)與腫瘤性質(zhì)的相關(guān)性研究　出處：《重慶醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 聽神經(jīng)瘤 聽力下降 純音測聽 聽性腦干反應(yīng) 囊性變

【摘要】：目的：描述聽力學(xué)檢查在聽神經(jīng)瘤診斷的作用,并探討其和腫瘤的囊實性相關(guān)性。方法：納入2004年1月-2015年1月重慶醫(yī)科大學(xué)第二附屬醫(yī)院耳鼻咽喉頭頸外科、神經(jīng)外科診斷的聽神經(jīng)瘤共57例。分析聽神經(jīng)瘤中臨床表現(xiàn)、純音聽閾、言語識別率、聲導(dǎo)抗(鼓室圖、鐙骨肌反射)、畸變耳聲發(fā)射、聽性腦干反應(yīng)的表現(xiàn)。根據(jù)腦MRI或術(shù)中腫瘤內(nèi)的囊性變分為囊性瘤和實性瘤,分析腫瘤囊性變和腫瘤大小、位置及年齡、性別、臨床表現(xiàn)和聽力學(xué)檢查的相關(guān)性。結(jié)果：聽神經(jīng)瘤的最常見癥狀包括聽力下降(84.21%)、耳鳴(52.63%)、眩暈(31.58%)、顱神經(jīng)損傷癥狀(17.54%)。純音聽閾表現(xiàn)為下降型(36.84%)、平坦型(28.07%),PTA64.24±21.67dB、SDS 36.37±28.04%, DPOAE正常有74.07%。鐙骨肌反射和ABR陽性分別80.49%、94.73%,聯(lián)合檢查的陽性率98.25%。囊性瘤呈現(xiàn)的瘤體更大、多位于內(nèi)聽道外腫瘤(P=0.009),囊性瘤的顱腦神經(jīng)損傷癥狀更多(P=0.044)。囊性瘤的PTA更差(P=0.014),但是SDS無顯著差異,囊實性瘤聽覺腦干誘發(fā)電位的潛伏期Ⅰ、Ⅲ、Ⅴ,潛伏間期Ⅰ-Ⅲ、Ⅰ-Ⅴ、 Ⅲ-Ⅴ,耳間差I(lǐng)LDV無顯著差異。囊性變的在ILDV(Ⅰ-Ⅴ)對側(cè)Ⅲ-Ⅴ/Ⅰ-Ⅲ更大(P=0.011、P=0.025)。結(jié)論：首診有聽力下降、耳鳴、眩暈表現(xiàn)的患者,均應(yīng)進(jìn)行PTA、 SDS.鐙骨肌反射、DPOAE、ABR檢查,當(dāng)PTA和SDS顯著差異,DPOAE正常、鐙骨肌反射陽性、ABR陽性考慮蝸后病變者,需行腦MRI檢查明確診斷。聽神經(jīng)瘤出現(xiàn)VIII顱神經(jīng)外的神經(jīng)癥狀,腫瘤多有囊性變,多是位于內(nèi)聽道外的大型腫瘤,PTA更差,ABR的ILD(Ⅰ-Ⅴ)、對側(cè)IPL(Ⅲ-Ⅴ/Ⅰ-Ⅲ)異常延長。
[Abstract]:Objective: to describe the audiological examination in the diagnosis of acoustic neuroma, and explore the correlation of cystic and tumors. Methods: a total of Otolaryngology Head and neck surgery, January 2004 -2015 year in January in the Second Affiliated Hospital of Medical University Of Chongqing, Department of Neurosurgery diagnosis of acoustic neuroma in 57 cases. Analysis of acoustic neuroma in clinical manifestations, pure tone audiometry, speech recognition, voice immittance (tympanogram stapedius reflex), distortion otoacoustic emission, auditory brainstem response performance. According to the brain MRI or cystic tumor in variational cystic tumor and solid tumor, analysis of tumor cystic degeneration and tumor size, location and age, sex, clinical manifestations and correlation audiological examination. Results: listen to the most common symptoms of neuroma include hearing loss (84.21%), tinnitus (52.63%), vertigo (31.58%), the symptoms of cranial nerve injury (17.54%). Pure tone audiometry showed decreased type (36.84%), flat type (28.07%), P TA64.24鹵21.67dB,SDS 36.37鹵28.04%, DPOAE姝ｅ父鏈，

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