小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 眩晕
- 听力损失
- 耳鸣
- 耳胀满感
- 发作性倾倒
其他诊断因素
- Romberg 征试验阳性
- Fukuda踏步试验
- 双侧症状
- 眼球震颤
- 脚跟脚尖直线行走试验
危险因素
- 近期病毒性感染
- 遗传易感性
- 自身免疫性疾病
诊断性检查
首要检查
- 带有掩蔽的纯音气导、骨导听阈测试
- 言语测听
- 鼓室导纳/导抗/镫骨肌反射测量
- 耳声发射（OAE）
需考虑的检查
- 耳蜗电图
- 眼震电图描记法
- 旋转椅试验
- 前庭诱发肌源性电位（VEMP）
- 内耳道MRI检查
- 甲状腺功能检测
- 莱姆病及梅毒血清学检查
- 抗核抗体
- 抗中性粒细胞胞浆抗体
- 类风湿因子
新兴检查
- 三维核磁共振检查
治疗流程
所有患者
持续的听力下降
药物治疗及鼓室内治疗失败；听力尚可
药物治疗及鼓室内治疗失败；听力严重受损
撰稿人
作者
Soha N. Ghossaini, MD, FACS
Otology-Neurotology
Ear Nose and Throat Associates of New York
New York
NY
利益声明
SNG has received sponsorship for BONEBRIDGE surgical training by MED-EL 2019.
鸣谢
Dr Ghossaini would like to gratefully acknowledge Professor Maurice H. Miller, a previous contributor to this topic. MHM declared that he had no competing interests. Unfortunately we have since been made aware that Professor Miller has passed away.
同行评议者
Steven D. Rauch, MD
Associate Professor of Otology and Laryngology
Harvard Medical School
Boston
MA
利益声明
SDR declares that he has no competing interests.
Christopher J. Linstrom, MD
Professor
Otolaryngology/Head and Neck Surgery
The New York Eye and Ear Infirmary
Surgeon Director
New York
NY
利益声明
CJL declares that he has no competing interests.
Peter Rea, MA, BM BCh, FRCS(ORL-HNS)
Consultant ENT Surgeon
Leicester Royal Infirmary
Leicester
UK
利益声明
PR declares that he has no competing interests.
Doris Eva Bamiou, MD, MSc, PhD
Clinical Senior Lecturer & Consultant in Audiovestibular Medicine
Ear Institute
University College London
London
UK
利益声明
DEB declares that she has no competing interests.
鉴别诊断
- 听神经瘤
- 前庭性偏头痛（亦称偏头痛性头晕或偏头痛性眩晕）
- 前庭神经元炎
更多 鉴别诊断指南
- 临床实践指南：梅尼埃病
- 临床实践指南：突发性听力丧失（更新）
更多 指南患者教育信息
耳鸣
梅尼埃病
更多 患者教育信息
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