| Background and ObjectiveSudden deafness is one of the most common emergencies in the ENT department.Dekleyn first reported sudden deafness in 1944,and people have gradually understood and valued it.In recent years,the incidence has increased,which seriously harms people Physical and mental health and quality of life.Sudden deafness is reported in the international consensus on the incidence of 5-30 people per 100,000 per year[1],and the incidence of sudden deafness in Germany in the 2004 guideline report was 20 per 100,000 in 2011.The new guideline report has increased to 160-400 persons per 100,000[2-3].Sudden sensorineural hearing loss in the United States affects 5 to 27 per 100,000 people,with approximately 66,000 new cases each year[4].Three epidemiological surveys in Japan found that the incidence of sudden deafness is increasing year by year[5],which is 3.9 per 100,000(1972),14.2 per 100,000(1987),19.4 per 100,000(1993)),27.5 people per 100,000(2001).The epidemiological study of sudden deafness in South Korea found that the average annual incidence rate was 17.76 cases per 100,000 people during 2011-2015,and it was on the rise[6].From the results of these large foreign sample data,it can be seen that the incidence of sudden deafness has increased significantly.At present,there is no large-scale epidemiological specific data in China,but clinically,there have been more patients with sudden deafness in recent years,and they have a younger trend[7].A large amount of data shows that sudden deafness occurs in young and middle-aged adults[8-10].It is generally believed that stress at work,mental stress,mood swings,irregular life,and sleep disorders may be the main causes of sudden deafness.Incentives.The common causes of sudden deafness are vascular diseases,viral infections,tumor compression on the cochlea nerve,toxic deafness,and congenital developmental abnormalities.These local and systemic factors may cause sudden deafness.If a clear etiology is found in the process,it should be modified to the corresponding disease according to the diagnosed etiology,such as acoustic neuroma,large vestibular aqueduct syndrome,etc[11].Sudden deafness patients not only have short-term hearing loss,but also can be accompanied by tinnitus,ear tightness,dizziness and other symptoms,affecting normal work and life,often causing panic in patients,and may have some degree of psychological and psychological symptoms.At present,due to the lack of high-quality clinical controlled studies,the causes and causes of sudden deafness are not clear.Although many meta-analyses and national guidelines have been issued,specific treatment plans(therapeutic drugs,routes of administration and duration of treatment))Scholars at home and abroad have not reached consensus,and management has not been standardized.Treatment effects vary widely and are associated with multiple prognostic factors.More high-quality clinical research and evidence-based medicine are needed.This study analyzes the clinical characteristics and treatment effects of young and middle-aged patients with sudden deafness,and provides a basis for clinical diagnosis,treatment and prognosis,and further improves the hearing recovery and quality of life of young and middle-aged patients with sudden deafness.Materials and methodsA total of 157 cases(162 ears)of young and middle-aged(19-59 years old)with sudden deafness who were admitted to our otolaryngology department from August 2018 to September 2019 and treated with the inclusion and exclusion criteria are complete Patients were included in the study.Admission patients complete related examinations and inspections,including pure tone audiometry,acoustic impedance,otoacoustic emission,and skull magnetic resonance,etc,All selected patients were referred to the China 2015 Sudden Deafness Treatment Guidelines and treated according to different hearing type curves.Analyze general patient information,pure tone audiometry results before and after treatment,and analyze young and middle-aged sudden deafness Clinical characteristics and prognostic factors.Statistical analysis was performed using SPSS 19.0.Results(1)There were 157(162 ears)young and middle-aged sudden deafness patients,83 in the left ear(52.87%),69 in the right ear(43.95%),5 in both ears(3.18%);among 152 patients with monoaural onset,The average age was 41.61 years,85 patients(55.92%)in the young group(19-44 years),67(44.08%)patients in the middle-aged group(46-59 years),78 males(51.32%),and 74 females(48.68%),And the sex ratio was 1.05:1;129 cases(84.87%)were accompanied by tinnitus,23 cases(15.13%)were not accompanied by tinnitus;61 cases(40.13%)accompanied with the feeling of ear fullness,and 91 cases(59.87%)Not accompanied with the feeling of ear fullness;97 cases(63.81%)of severe and severe deafness;109 cases(71.71%)of flat and fully deaf;126(82.9%)of them were seen within 1 week of onset;(2)Forty-nine patients(32.24%)had vertigo symptoms,of which 16 were BPPV with sudden deafness(11 cases were posterior semicircular canal,4 cases were horizontal semicircular canal,1 case was multiple semicircular canal);Corresponding reduction treatments included 9 patients(56.25%)with 1 reduction,and the symptoms of vertigo improved significantly.3 patients(18.75%)required 2 reductions,and 4 patients(25.00%)required 3 reductions.(3)In the univariate analysis that may affect the prognostic factors,the affected ear side,age,gender,and whether there is tinnitus,tinnitus,and basic disease have no significant effect on the prognosis(P>0.05),and the duration of illness at the time of consultation(?2=6.255),P=0.044),deafness(?2=9.260,P=0.026),anxiety and depression(?2=5.371,P=0.020),vertigo(?2=8.089,P=0.018),type of hearing curve(?2=12.206,P=0.007),the significance of P were all less than 0.05;the results of multivariate binary logistic regression analysis showed that the duration of illness,anxiety and depression psychological problems,and dizziness had significant effects on the prognosis,P<0.05.Conclusions(1)Young middle-aged sudden deafness rarely occurs in both ears,more in the left ear than in the right ear,slightly more in men than women,and is often accompanied by tinnitus,which can be accompanied by symptoms of ear tightness and vertigo.Some of the patients with vertigo are BPPV Vertigo(mostly posterior semicircular canal BPPV);and otolith reduction is effective for sudden deafness with BPPV type vertigo;(2)Whether it is accompanied by dizziness,the length of illness at the time of consultation,the degree of deafness,anxiety and depression,and the type of hearing curve may be the factors affecting the prognosis of sudden deafness.The length of illness,anxiety and depression psychological conditions at the time of treatment,and the type of hearing curve are the influencing factors of sudden deaf prognosis;(3)Young and middle-aged patients with sudden deafness need comprehensive and timely treatment(drugs and psychology)in order to improve the efficacy of deafness and the quality of life in the later stage. |
PDF Full Text Request