The Study Of Clinical Characters And Prognosis Of Bilateral Sudden Sensorineural Hearing Loss

Objective: The bilateral sudden sensorineural hearing loss is rare, and its pathogenesis is not clear. But the study of sudden sensorineural hearing loss in domestic and foreign lack clinical evidence, BSSHL treatment effect is still no unified conclusion. To analyse clinical characteristics and treatment effect of the bilateral sudden sensorineural hearing loss patients, to understand the related factors influencing the development and prognosis of BSSHL.Methods:Collecting the inpatients of bilateral sudden sensorineural hearing loss who treated in the PL A general hospital from June2008to September2013. With relative complete clinical data of61cases, the gender, age, course of the disease, the history, clinical characteristics, audiology examination, blood tests, imaging examination, treatment methods and curative effect were retrospectively statistics and analysis, to study the risk factors affecting prognosis.Results:1.61cases of bilateral sudden sensorineural hearing loss, who accounting for5.08%of all patients with sudden sensorineural hearing loss (1200cases). Among them35males (57.38%) and26females (42.62%), the ratio is1.35:1. Age from4-85years, up to40-49(17cases), average age is43.15years.2. The simultaneous BSSHL is39cases (63.93%), successive BSSHL is22cases (36.07%).23cases has clear inducing factors, in them7cases have a cold and fever,5cases is fatigue, medication after onset in3cases,3cases caused by noise, after drinking is2cases,the collision of head in2cases and parotitis1case.78ears (63.93%) of61patients (122ears) with tinnitus, and21cases (34.43%) with vertigo. 3. In audiology, about two-thirds (65.57%) of patients are symmetrical hearing loss. According to the degree of hearing loss grouping: mostly is severe (22.95%) and profound(40.98%). Grouping by hearing curve type to flat type (32.79%) and total deafness in the majority (40.16%).4. In blood tests,45cases with routine blood tests,7cases(15.5%) with abnormal WBC count;19cases giant cell antibody detection, including9cases (47.37%) abnormal. IgA antibody testing is21cases, including1case abnormal (4.76%);20cases IgE antibody detection, including4cases (20%) increased.25cases with serum thyroid stimulating hormone testing, of which the abnormal increase in2cases (8%). Biochemical examination, glucose determination is45cases,8cases (17.78%) increased.5. In accessory examination,61cases are doing electrocardiograph,30cases is abnormal(49.18%); Temporal bone CT, MRI and internal auditory canal liquid imaging has no abnormal was found in all patients; Carotid ultrasound examination is32cases, including21cases in carotid atherosclerosis with plaque formation (65.63%); Vertebral artery ultrasound32cases, including3cases in carotid atherosclerosis plaque formation (9.38%).6. The total effective rate of treatment was23.77%. The relationship between the factors, which including age, the simultaneous and subsequently BSSHL, degree of hearing loss, hearing curve type, whether with tinnitus or dizziness and the time between onset and seeing a doctor, electrocardiogram, carotid ultrasoundaffecting the prognosis, and prognosis.In statistical analysis, the differences were not significant (P>0.05).Conclusion:1.The incidence of bilateral sudden sensorineural hearing loss is rare.The incidence of men and women,there are no obvious difference. Have a trend of getting younger over the onset age. Severe and profound hearing loss is in the majority, hearing curve type mostly is flat and total all frequency hearing loss. BSSHL has poor prognosis compared with unilateral sudden sensorineural hearing loss. 2.Causes attribute to virus infection, autoimmune, blood rheology changing, tumor and poisoning.3.Due to the complexity of BSSHL, the prognosis is poor. Compared with unilateral sudden sensorineural hearing loss, they are two different diseases, and need different research. Because it is often an acute performance,which is the serious underlying disease related to high morbidity and mortality.lt should be emergency treated and formulate individualized therapeutic regimen, in order to achieve better therapeutic effect.