聽神經瘤與聽力檢查頻率的相關性

小腦橋腦角（cerebellopontine angle，CPA）腫瘤是後顱窩最常見的腫瘤，約占顱內腫瘤的5～10%，其中聽神經瘤（acoustic neuroma）又占CPA的80～90%，從腫瘤生長的位置及大小可能影響第五對腦神經（三叉神經）、第七對腦神經（顏面神經）及第八對腦神經（前庭耳蝸神經），進而產生聽力損失、耳鳴、平衡問題、顏面神經弱化等問題，其中又以聽力損失為最常出現的症狀（占90%）。聽神經瘤的患者，可以經由聽力學的檢查來加以診斷，在聽力圖上常會呈現不對稱型聽力損失（asymmetrical hearing loss），對於不對稱聽損的定義在各個文獻上有些許不同。本研究以臨床上聽力檢查所做的頻率：250、500、1000、2000、4000及8000Hz，兩耳相差15dB為切點，收集2016～2018年上半年度聽性腦幹反應檢查異常的患者，共72位研究個案，其中確診15位有聽神經瘤，11位為男性（73.33%）、4位為女性（26.67%），以50～59歲這個年齡層占的比例最高（40.00%），此研究分析有聽神經瘤個案在上述6個頻率分別與年齡和性別之相關性。分析結果顯示，頻率為2000Hz之兩耳相差15dB以上與聽神經瘤有統計上達顯著相關（p＝0.027），然而年齡及性別皆與聽神經瘤的發生率並未達顯著相關。但有相關並不代表有因果關係，此結果僅做為臨床上聽力師及醫師預測不對稱聽損及聽神經瘤間判讀上面的參考。

關鍵字

不對稱聽力損失；聽神經瘤

並列摘要

Cerebellopontine angle (CPA) tumors are the most common neoplasms in the posterior fossa, accounting for 5-10% of intracranial tumors. Acoustic neuroma accounts for around 80-90% of CPA lesions. As acoustic neuroma grows, it may be more likely to cause more noticeable or severe signs and symptoms: asymmetrical sensorineural hearing loss, tinnitus, dizziness, etc. Acoustic neuroma is diagnosed according to the results of hearing tests and imaging tests. Asymmetrical hearing loss is the most common symptom in acoustic neuroma patients (90%). There are several different definitions of asymmetrical hearing loss reported in the literature. This study collected patients in Chiayi Christian Hospital from January 2016 to June 2018, who were diagnosed with acoustic neuroma. We used asymmetrical definition, by interaural hearing threshold level difference of 15 dB and more across the frequency 250, 500, 1000, 2000, 4000, and 8000 Hz, to determine the correlations between these frequencies and acoustic neuroma. The results showed that ＂interaural hearing threshold level difference of 15 dB and more at 2000 Hz＂ revealed statistically significant difference (p value = 0.027).

並列關鍵字

Asymmetrical hearing loss ； Acoustic neuroma

參考文獻

Ahsan, S. F., Standring, R., Osborn, D. A., Peterson, E., Seidman, M., & Jain, R. (2015). Clinical predictors of abnormal magnetic resonance imaging findings in patients with asymmetric sensorineural hearing loss. JAMA Otolaryngology-Head & Neck Surgery, 141, 451-456. doi:10.1001/jamaoto.2015.142

Bonneville, F., Sarrazin, J.-L., Marsot-Dupuch, K., Iffenecker, C., Cordoliani, Y.-S., Doyon, D., & Bonneville, J.-F. (2001). Unusual lesions of the cerebellopontine angle: A segmental approach. RadioGraphics, 21, 419-438. doi:10.1148/radiographics.21.2.g01mr13419

Briggs, R. J. S., Luxford, W. M., Atkins, J. S., Jr., & Hitselberger, W. E. (1994). Translabyrinthine removal of large acoustic neuromas. Neurosurgery, 34, 785-791. doi:10.1097/00006123-199405000-00001

Celikkanat, S. M., Saleh, E., Khashaba, A., Taibah, A., Russo, A., Mazzoni, A., & Sanna, M. (1995). Cerebrospinal fluid leak after translabyrinthine acoustic neuroma surgery. Otolaryngology-Head and Neck Surgery, 112, 654-658. doi:10.1016/S0194-59989570171-0

Corona, A. P., Oliveira, J. C., de Souza, F. P. A., Santana, L. V., & Rêgo, M. A. V. (2009). Risk factors associated with vestibulocochlear nerve schwannoma: Systematic review. Brazilian Journal of Otorhinolaryngology, 75, 593-615. doi:10.1016/S1808-8694(15)30501-2

國際替代計量

聽神經瘤與聽力檢查頻率的相關性

全文下載

主題瀏覽