Analysis Of Clinical Characteristics And The Short-term Treatment Outcome Of Idiopathic Sudden Sensorineural Hearing Loss And Concomitant Benign Paroxysmal Positional Vertigo

Objective: To analyze clinical characteristics and the short-term treatment outcome of the patients of idiopathic sudden sensorineural hearing loss(ISSHL)and concomitant benign paroxysmal positional vertigo(BPPV),and to explore the possible pathogenetic mechanism and treatment.Methods:Analyzed the 260 clinical information of patients treated in the department of otorhinoraryngoolgy of Tianjin People`s Hospital from January,2015 to June,2016 and diagnosed with unilateral ISSHL.According to whether concomitant BPPV,the260 patients divided into two groups,one is ISSHL with BPPV,anther is without BPPV.Analyzed clinical characteristics of the patients of SSHL with BPPV.All SSHL patients` duration of disease were one to ten days.According to frequency and degree of the hearing loss of ISSHL patients,the hearing curve were divided into four types :cute hearing loss in low tone frequencies,acute hearing loss in high tone frequencies,acute hearing loss in all frequencies and total deafness.The ISSHL patients with different hearing curves were treated with different therapeutic methods within fourteen days.Analyzed the effective treatment rate of the ISSHL patients with BPPV and without BPPV.Analyzed the 100 clinical information of patients diagnosed with idiopathic BPPV.The idiopathic BPPV patients were the control group.All BPPV patients were treated using G-force.A week after treatment,the idiopathic BPPV patients were tested Dix-Hallpike test and roll test again.Patients who were not cured were treated again.Analyzed effective treatment rate and treatment numbers of the ISSHL patients with BPPV and the idiopathic BPPV patients.All BPPV patients were follow-up three months by phone or outpatient care.The patients of recurrence were recorded and treated again.Outcome date were analyzed using SPSS21.0.Results: 1.The incidence of the ISSHL patients with BPPV was about 14.62% in the ISSHL patients and 38.38% in the ISSHL patients with vertigo.Female:male was1.92:1.The average age of the ISSHL patients with BPPV was(49.18±9.78)years old.The ISSHL patients with BPPV were diagnosed as the same ears as the ISSHL patients and mainly occurs in the posterior semicircular canal(55.26%).The onset of BPPV was later than ISSHL.The type of total deafness was the most hearing curve in the ISSHL patients with BPPV,around about 42.11%.The cute sensorineural hearing loss in low tone frequencies hearing curve was the least(2.63%).2.The ISSHL patients with BPPV and the idiopathic BPPV patients were cured after 1-4 times treatment.The efficiency rate of the idiopathic BPPV patients was higher than the ISSHL patients with BPPV(P<0.05).3.The hearing improvement efficiency rate of the ISSHL patients without BPPV is higher than the ISSHL patients with BPPV(P<0.05).The PTA after treatment of two groups was recovered.The PTA after treatment of the ISSHL patients with BPPV is higher than the ISSHL patients without BPPV(P<0.05).4.All BPPV patients were follow-up three months,and the recurrence rate of the ISSHL patients with BPPV and the idiopathic BPPV had no difference(P>0.05).Conclusion: 1.The average age of the ISSHL patients with BPPV was(49.18±9.78)years old.More women than men.The ISSHL patients with BPPV were diagnosed as the same ears as the ISSHL patients and mainly occurs in the posterior semicircular canal.The onset of BPPV was later than ISSHL.The type of total deafness was the most hearing curve in the ISSHL patients with BPPV.2.The efficiency rate of all BPPV were 100%.But 1 time treatment efficiency rate of the idiopathic BPPV patients was higher than the ISSHL patients with BPPV(P<0.05).The hearing improvement efficiency rate of the ISSHL patients without BPPV is higher than the ISSHL patients with BPPV(P<0.05).3.The pathogenetic mechanism of the ISSHL patients with BPPV was obscure like ISSHL and BPPV.The possible pathogenesis is the common factors which can make cochlear and vestibule hurt.The common pathogenic factors were inner ear vascular factors and virus infection.4.The ISSHL patients with BPPV were treated to improve the inner ear circulation,and were treated by hormone,canalith repositioning maneuvers and metal intervation,the treatment outcome of the most patients was satisfying.