Causes of sudden deafness
The cause of sudden deafness is unknown, and many pathogenic factors may lead to sudden deafness. At present, there are mainly virus infection theory, circulatory disorder theory, autoimmune theory and membrane labyrinth rupture theory.
1, virus infection theory
Many viruses may be related to this disease, including cytomegalovirus, mumps virus, rubella virus, measles virus, herpes simplex virus, influenza A and B virus and varicella virus. Many patients have a history of upper respiratory tract infection and mumps in winter and spring, and their hearing loss is serious. Before the onset of the disease, they often have a history of contact or illness with colds or mumps, suggesting that this disease is closely related to viral infection.
2. Circulatory disorder theory
At present, it is generally believed that the blood supply disorder of the inner ear is the main cause of sudden deafness, and the degree of hearing loss of patients is related to the cochlear blood flow velocity, blood flow and vascular cross-sectional area. The blood supply of the inner ear comes from the labyrinthine artery. Inner ear hair cells consume more oxygen in physiological activities and have poor hypoxia tolerance. The decrease of blood pressure or circulating carbon dioxide partial pressure may cause the oxygen tension of lymph outside the cochlea to decrease, thus reducing the oxygen supply to the inner ear and causing hearing loss.
3. Autoimmune theory
Autoimmune theory is a relatively new pathogenesis of sudden deafness. Epidemiological studies show that some autoimmune diseases such as Cogan syndrome, temporal arteritis, systemic lupus erythematosus and polyarteritis nodosa are all related to sudden deafness.
4. Membrane rupture theory
Rupture refers to the rupture of the round window membrane or vestibular membrane of the inner ear, combined with the rupture of cochlear membrane. It is found that there may be some defects in the anatomy of the patient's inner ear, which may lead to the rupture of the window membrane and sudden deafness under the conditions of craniocerebral injury, forced cough, vomiting or sneezing, as well as barotrauma, diving and swimming.
5. Other theories
There are other theories about the pathogenesis of sudden deafness, such as metabolic disorder, inner ear edema, allergy, vascular stria dysfunction and so on, which need to be verified. Clinically, most patients have no obvious etiology, and some patients have obvious fatigue, emotional excitement, mental tension and cold history, which may be related to the onset.
Treatment of sudden deafness
At present, the treatment of sudden deafness mostly adopts comprehensive treatment, and the effective rate is about 70%. The time of starting treatment is related to the prognosis, and treatment should be done as soon as possible within 7- 10 days after onset.
1, glucocorticoid
Glucocorticoids commonly used in clinic are: prednisone, 1mg/kg, taken orally, 1 time a day, taken in the morning and gradually reduced. Dexamethasone intravenous drip can also be used for a short time.
2. Drugs for improving inner ear microcirculation
Include ginkgo biloba preparation, salvia miltiorrhiza preparation, prostaglandin, histamine, nicotinic acid, procaine, scopolamine, low molecular dextran, etc. It can be combined with drugs to promote the functional recovery of nerve cells.
3. Thrombolytic and anticoagulant drugs
Donglingdefu and Agkistrodon halys antithrombotic enzyme have the effects of reducing blood viscosity, inhibiting platelet and erythrocyte aggregation and improving microcirculation, and can be used for the treatment of sudden deafness. But when using this kind of drugs, we must pay attention to monitoring the level of fibrinogen and adjust the medication according to the test results.
4. Neurotrophic drugs
Commonly used neurotrophic drugs are adenosine triphosphate and vitamins. Adenosine triphosphate (ATP) is a coenzyme and the main energy source of the body. Because of its function of improving metabolism, it has become one of the main drugs to treat sudden deafness.
5. Hyperbaric oxygen therapy
Hyperbaric oxygen therapy can alleviate edema and ischemia-hypoxia injury of inner ear, improve inner ear circulation, obviously increase oxygen partial pressure of blood and tissue cells, blood volume in plasma and diffusion radius in tissues, accelerate the repair of inner ear hair cells and vestibular nerve fibers, and also reduce platelet aggregation and blood viscosity, so it can be used for the treatment of sudden deafness. The therapeutic effect is related to the onset time. With the accumulation of treatment experience, the curative effect of hyperbaric oxygen combined with drugs is better than that of hyperbaric oxygen alone.
Symptoms of sudden deafness
Of course, the most obvious symptom of sudden deafness is deafness, followed by tinnitus, dizziness and ear blockage.
1, deaf The disease is fierce, which can cause hearing loss in an instant, hours or days, and sudden deafness in the morning. Deafness of the slow person can be gradually aggravated, and the progress stops after a few days, ranging from mild to total deafness. It can be temporary or permanent, mostly unilateral, and occasionally both sides happen at the same time or successively. It can be cochlear deafness or post-cochlear deafness.
2, tinnitus. Tinnitus often occurs before and after deafness, accounting for about 70%. It usually appears a few hours before deafness, mostly buzzing, and lasts for 1 month or longer. Some patients may emphasize tinnitus and ignore hearing loss.
3. dizziness. About 2/5 days, 1/2 sudden deafness is accompanied by dizziness of different degrees, of which about 10% is severe deafness, nausea and vomiting, which lasts for 4 ~ 7 days, and mild dizziness can exist for more than 6 weeks. A few patients come to see a doctor with vertigo as the main symptom, which is easily misdiagnosed as Meniere's disease. Relieved after a few days, no recurrent attacks.
4. Ears are blocked. Patients will have a feeling of ear blockage, which usually appears before deafness.
5, nystagmus. If the patient has dizziness, then there may also be spontaneous nystagmus.
6. Others: A few patients may feel stuffy, oppressed or numb.
Friends with the above sudden symptoms must be treated with caution to guard against sudden deafness.
What is good for sudden deafness?
Experts pointed out that from a medical point of view, tinnitus caused by sudden deafness is an emergency, which requires timely medical treatment, generally not more than 3 days. If the treatment is delayed all the time, it will cause serious damage to hearing. After a few days, hearing may decline or even disappear, leading to deafness. Therefore, even after timely treatment, proper health care should be done in the diet of prognosis. Otolaryngologists introduce the dietary health care work of sudden deafness as follows:
1. Patients with sudden deafness should supplement some foods rich in protein and vitamins, such as lean meat, beans and various green leafy vegetables.
2. Patients with sudden deafness should eat more foods containing zinc, such as fish, chicken, chicken liver, eggs and various seafood.
3, eat more foods rich in magnesium, common foods are bananas, pineapples, walnuts and so on.
4. Eat more foods rich in vitamin D and calcium. Common foods are skim milk, bone soup, calcium tablets and so on.
5, drink more milk, milk is very nutritious.
6, sudden deafness patients diet should be light and nutritious, reduce warm and dry food, avoid drinking strong tea, coffee, wine and other stimulating drinks before going to bed.
All of the above are beneficial to the diet of patients with sudden deafness. Through proper diet, we can adjust the nutrients that the human body lacks and play a very important role in the recovery of diseases.
Examination of sudden deafness
Sudden deafness is one of the acute diseases. If it is not treated in time, it is likely to cause serious consequences. So, what are the examination items for sudden deafness? Let me introduce it to you.
1, ask the medical history in detail. Patients with sudden deafness caused by viral infection can clearly provide the history of influenza, cold, upper respiratory tract infection, sore throat, sinusitis and so on. , or contact with virus-infected people, can appear a few weeks before hearing loss. Sudden deafness caused by vascular diseases can provide a history of heart disease or hypertension, diabetes, arteriosclerosis, hypercholesterolemia or other systemic diseases affecting the microvascular system. Most patients with labyrinthine membrane rupture have a clear history of exertion or pressure change, such as dysuria, defecation, cough, sneezing, bending over and laughing, or swimming, diving, diving with snorkel or underwater respirator or abnormal flight activities.
2. General inspection. The cardiovascular system, coagulation system, metabolism and immune reactivity of the body should be targeted, and the neurological examination should exclude the lesions of the internal auditory canal and cerebellopontine angle, the obstacles of the vertebral base and cerebrovascular circulation, such as the internal auditory canal film and cervical vertebra film, skull CT scan, fundus and cerebral rheogram examination.
3. Laboratory examination. Including hemogram, erythrocyte sedimentation rate, coagulation time, prothrombin time, platelet count and so on. Serological examination of virus isolation and antibody titer determination can also consider blood sugar, blood lipid, blood nitrogen and serum syphilis test.
4, otoscopy. The eardrum is often normal or reddish.
5. Listening test. To understand the nature, degree and dynamics of hearing loss.
6. Vestibular function examination. If necessary, make an electronystagmogram.
Prevention of sudden deafness
According to relevant data, the incidence of deafness in China is increasing year by year, especially sudden deafness. Therefore, it is particularly important for everyone to learn to protect their ears and prevent deafness or sudden deafness.
1. Use ototoxic drugs with caution. Aminoglycoside antibiotics such as streptomycin, neomycin, kanamycin and gentamicin can enter the inner ear by oral administration, injection or ear drops, which will damage the hearing organs of the inner ear. If a large number of drugs are used, they will become irreversible lesions. Therefore, these drugs should not be used during the day. If necessary, the minimum effective dose should be used, supplemented by a large number of vitamins, vasodilators and drugs to promote blood circulation and metabolism to protect the inner ear.
2. Actively prevent and control infectious diseases. Some viral or bacterial infectious diseases, such as influenza, rubella, scarlet fever, meningitis, mumps, measles, etc. , can directly invade the hearing organs, damage the hearing function. Although most people can get timely and appropriate treatment now, deafness is rare, but its deafness is serious, which should also be paid attention to.
3. Eliminate pathogenic factors of external ear. Ear malformation, external auditory canal atresia, cerumen, foreign body, furuncle, trauma, tumor, etc. Conductive deafness may be caused by obstacles in collecting and conducting sound waves.
4. Actively prevent middle ear diseases. Diseases of tympanic membrane and eustachian tube, suppurative otitis media or non-suppurative otitis media can all cause tympanic membrane perforation, invagination, tympanic effusion, adhesion and interruption of auditory green chain, which will change the sound transmission physiology of middle ear and cause hearing impairment. According to different situations, measures such as medication, eustachian tube blowing, tympanic membrane repair, tympanic drainage, intubation and reconstruction of middle ear sound transmission mechanism should be given to restore or partially restore the lost hearing.
5. Control the noise in the living and working environment and strengthen personal protection. Long-term exposure to high-intensity noise will lead to necrosis of inner ear tissues and cells. Therefore, the prevention of deafness is the focus of labor insurance and health work. Noise intensity should be monitored in high noise workshops and noise protection standards should be formulated. Where the noise exceeds the standard, the workshop should be reformed, isolation and noise elimination equipment should be adopted, the machine should be reformed to reduce the noise, and individuals should wear protective earplugs and helmets or shorten the time of exposure to noise. Workers should check their hearing regularly, and if they find deafness, they should change their working environment.