急性感音難聴　　１診療所における６年間２２７症例の検討

DOI PubMed 被引用文献4件 参考文献18件

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  • Acute Sensorineural Hearing Loss in 227 Outpatient Cases.

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Subjects were 227 patients with acute sensorineural hearing loss of 17, 146 patients seen at our ear, nose, and throat (E.N.T.) outpatient clinic from October 1994 through September 2000.<BR>Of these, 45 suffered from profound and moderate idiopathic sudden hearing loss diagnosed when the arithmetical mean of hearing thresholds at 0.25, 0.5, 1, 2, and 4 KHz was 40 dB or worse. Of the 30 patients whose medical treatment was started within 7 days of onset, 18 (60%) showed excellent or complete recovery of hearing, whereas none of the 15 whose treatment was started 8 days or late after onset showed satisfactory improvement. In general, the sooner treatment was started, the better hearing recovered.<BR>Idiopathic acute low-tone sensorineural hearing loss was found in 111 (49%) patients with a female preponderance at a M: F ratio of 1: 2.3, but no gender difference was seen in other diseases. The most common symptom was a feeling of pressure or fullness in the affected ear. Only 16% of patients were aware of their hearing disturbance. Some 73 (66%) showed complete recovery.<BR>Meniere's disease was diagnosed in 13, in whom hearing improved in only 2 (15%). Probable Meniere's disease was diagnosed in 9 patients who had 1 definitive episode of vertigo with low-tone sensorineural hearing loss, and their prognosis was good.<BR>The prognosis in 7 patients with hearing loss due to acoustic trauma and 1 with psychogenic hearing loss was good, but normal hearing was not restored in 1 with mumps or 1 with acoustic neurinoma.<BR>A patient with diabetic nephropathy had low-tone hearing loss and nystagmus toward the affected ear. Attacks of vertigo were controlled by diuretic therapy, but hearing recovery occurred by a little less than 10 dB.<BR>Some 35 patients had mild idiopathic hearing loss and prognosis was relatively good. Hearing was disturbed after head injury in 2 and after nose blowing in 1, probably attributable to concussion of the labyrinth or the formation of a perilymphatic fistula. The diagnosis of this condition could not be made with certainty by surgical exploration of the ear.

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