兩側同時突發性聽力喪失－病例報告

Bilateral Simultaneous Sudden Hearing Loss – Case Report

吳毓祥(Yu-Hsiang Wu) ； 楊怡和(Yi-Ho Young)

《中華民國耳鼻喉科醫學會雜誌》 32卷6期 (1997/12) Pp. 701-706

https://doi.org/10.6286/1997.32.6.701

摘要

背景：兩側同時突發性聽力喪失在臨床上並不常見，約佔所有突發性耳聾的0.44%到2.78%之間。此症發生的原因，有別於一般之單側突發性聽力喪失，通常多因全身性疾患侵犯兩耳所致。本報告提出過去6年來的臨床經驗，加以討論。
方法：自1991年至1996年間，本科共8例診斷為兩側同時突發性聽力喪失。針對其神經學檢查、聽力學檢查、及眼振電圖檢查，加以分析。
結果：8例的兩側同時突發性聽力喪失，有2例屬突發性耳聾，其神經學及眼振電圖檢查均正常，聽力圖呈兩側左右對稱形式。其餘6例則均有致病原因，計腦腫瘤1例，腦中風1例，腦膜炎1例，耳中毒症2例，及Vogt-koyanagi-Harada (VKH)症候群1例。其神經學檢查多有異常，如顏面神經麻痺等。聽力圖除1例VKH症候群外，餘皆為非對稱性聽力喪失。眼振電圖檢查亦出現許多異常的中樞性徵象。
結論：面對兩側同時突發性聽力喪失的病人，醫師應根據其臨床症狀、聽力圖型、及眼振電圖所見，做系統性之探查，積極找尋是否有其他全身性致病因，予以鑑別診斷，俾對症治療。

關鍵字

兩側同時突發性聽力喪失 ； 突發性耳聾

並列摘要

Background: Bilateral simultaneous sudden hearing loss is very rare, ranging from 0.44% to 2.78% in patients with sudden hearing loss.
Materials and methods: There were 8 patients with bilateral simultaneous sudden hearing loss from 1991 to 1996. All received a battery of tests, including physical examination, neurological examinations, laboratory tests, audiometry and electronysta-gmography.
Results: Two of the eight patients were diagnosed with idiopathic bilateral simultaneous sudden deafness, and the audiograms revealed symmetrical patterns. The other six patients had underlying diseases, specifically brain tumor 1, stroke 1, meningitis 1, ototoxicity 2 and VKH syndrome 1. In the case of the patient with VKH syndrome, the audiogram also revealed a symmetrical pattern; whereas asymmetrical audiograms were encountered in the other 5 patients.
Conclusion: With the use of neurological examinations, audiograms and electronys-tagmograms, one can make an effective differential diagnosis in patients with bilateral simultaneous sudden hearing loss.

並列關鍵字

bilateral simultaneous sudden hearing loss ； sudden deafness