腦幹聽性反應診斷不對稱感覺神經性聽力損失患者耳蝸後病變之有效度

Efficacy of Auditory Brainstem Response in Diagnosis of Retrocochlear Lesions for Patients with Asymmetric Sensorineural Hearing Loss

許權振(Chuan-Jen Hsu) ； 林榮浩(Jorng-Haung Lin) ； 林凱南(Kai-Nan Lin) ； 林嘉德(Jia-Der Lin)

《中華民國耳鼻喉科醫學會雜誌》 32卷4期 (1997/08) Pp. 371-377

https://doi.org/10.6286/1997.32.4.371

摘要

兩耳不對稱感覺視經性聽力損失的病人在耳鼻喉科門診相當常見，診斷此類病人是否有耳蝸後病變，在臨床上非常重要。純音聽力圖顯示雙耳不對稱感覺視經性聽力損失且接受腦幹聽性反應檢查和磁振影像檢查病人46名，男性28名，女性18名，年齡分佈由25歲至78歲。影像檢查證實存鄉聲蝸後病變的病側耳16個，影像檢查無耳蝸後病變的病側耳32個，比較此48個病側耳的腦幹聽性反應檢查結果和像檢查結果。將腦幹聽性反應無法判讀的8耳除外，影像檢查顯示有耳蝸後病變且腦幹聽性反應檢查懷疑有耳蝸後病變者12耳，影像檢查無耳蝸後病變且腦幹聽性反應檢查不疑耳蝸後病變者20耳，則腦幹聽性反應檢查偵測耳蝸後病變之靈敏度為80%(12/15)，特異度為80%(20/25)。對於腦幹聽性反應結果在正常值上限邊緣或偽陽性者應長期追蹤，我們建議此類病人應於6-9個月後再評估其臨床變化並重複聽力檢查和腦幹聽性反應檢查。(中耳醫誌 1997;32:371-377)

關鍵字

不對稱感覺視經性聽力損失 ； 腦幹聽性反應檢查 ； 耳蝸後病變 ； 有效度

並列摘要

We experienced 46 patients with asymmetric sensorineural hearing loss. All patients received auditory brainstem response (ABR) and magnetic resonance imaging examinations. The image findings revealed 14 cases of retrocochlear lesions; including brainstem infarction, cerebellopontine angle tumors (2 cases with bilateral tumors), cochleovestibular neuritis and arachnoid cyst. The ears with nonconclusive ABR results were excluded in this study. For those retrocochlear lesions, the retrocochlear signs of ABR were positive in 12 ears and negative in 3. Negativeimage findings were noted in 25 cases and negative ABR findings in 20. For diagnosis of the retrocochlear lesions with ABR, the sensitivity and the specificity were 80% (12/15) and 80% (20/25) respectively. Therefore, ABR is an effective and accurate tool in neurotology.

並列關鍵字

asymmetic sensorineural hearing loss ； auditory brainstem response ； retrocochlear lesion ； efficacy