聽力障礙型態與異常耳蝸循環病因關係的推測

本研究的目的是從模式動物的實驗結果來推論突發或耳聾，早質梅尼爾氏病，及老年性失聰等三種聽力障礙型態與耳蝸血汳循環障礙之間的可能關聯。動物實驗是將天竺屬供應內耳血液循九的迷路動脈予以60至90分鐘的暫時性阻塞，隔2至10星期後取出耳蝸，觀察耳蝸內部柯氏器的變化我們發現主司低頻率聲音感覺且位於循環末梢的耳蝸頂迴轉變化最大，其外毛細胞破壞最多。位於循環近端且主司高頻感覺的基底迴轉變化最少。因此我自認為循環障礙較容易引起低音性的聽力障礙。突發性耳聾50名病例，經混合方式的治療後，有20例平均聽力改善超10dB，其餘30例則否。我們發現治療後聽力有改善的病例發病時之低頻聽力，包括125Hz、250Hz呈有意義之隆低，顯示此類病變可能由血液循環障礙引起，而其預後較好的情形亦可以此來解釋。早質梅尼爾氏病有20例(28耳)，其低頻聽力，包括125Hz、250Hz及500Hz，均比1000Hz及亦即低頻較為明顯的聽力障礙。老年性失聰之31例(62耳)，聽力均呈高音漸傾型，很難以急性之血液循環障礙來解釋。

關鍵字

耳蝸血液循環；突發性耳聾；梅尼爾氏病；老年性失聰

並列摘要

The purpose of this study is to evaluate the possible role of circulatory disturbance in the pathogenesis of inner ear disorders including sudden deafness, Meniere’s disease and presbycusis. Labyrinthine artery of guinea pigs was clamped temporarily for 60 to 90 min and histopathologic picture of the organ of Corti was used as a Basis for comparison in this hypothetical evaluation. After a period of 8 to 10 weeks, cell degeneration in the cochlea was found mainly at the outer hair cells in the apical turn which is for low tone hearing and least in the basal turn mainly for high tone hearing. Thus we speculated that circulatory disturbance might induce low tone hearing loss. Clinically, among 50 cases of sudden deafness, 20 patients had hearing improvement of over 10dB after combined treatment. In these 20 cases, the low tone threshold at disease onset was found significantly higher than that of the other 30 cases who did not show hearing improvement after therapy. This suggests that acute low tone hearing loss may result fro circulatory disturbance of the inner ear. Since the low frequency hearing was affected in the early stage of Meniere’s disease, we think that circulatory problem may also contribute to the pathogenesis of this disease. As for resbycusis, it is difficult to correlate the high tone hearing loss with circulatory abnormality.

並列關鍵字

cochlear blood flow ； sudden deafness ； Menier's disease ； presbycusis

國際替代計量

聽力障礙型態與異常耳蝸循環病因關係的推測

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