最近审阅: 23 十月 2020
最近更新: 16 十月 2018

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 药物治疗史
  • 发作性耳鸣
  • 听力受损
  • 眩晕
  • 搏动性耳鸣
  • 滴答声
  • 视觉变化
  • 出现杂音或哼鸣
  • 颅神经麻痹
  • 耵聍(耳垢)
  • 耳镜检查异常
  • 韦伯试验异常
  • 林纳试验异常

其他诊断因素

  • 缓慢起病的进行性听力损失
  • 高调
  • 低调
  • 单侧耳鸣
  • 双侧耳鸣
  • 咀嚼时加重
  • 烦渴/多饮
  • 腹泻
  • 心悸
  • 异物

危险因素

  • 老年
  • 听力受损
  • 噪声暴露
  • 前庭神经鞘瘤
  • 耳毒性药物
  • 重金属暴露
  • 脑血管病史
  • 多发性硬化的病史
  • 颅脑创伤病史
  • 抑郁史
  • 焦虑病史

诊断性检查

需考虑的检查

  • 全血细胞计数 (FBC)
  • 甲状腺功能检测
  • 血脂检查
  • 空腹血糖
  • 荧光密螺旋体抗体吸收试验
  • 头部 MRI
  • 颞骨 CT
  • MR 血管成像或 CT 血管造影术
  • 颈动脉血管造影术
  • 听性脑干反应(ABR)
  • 最小掩蔽级
  • 残余抑制
  • 强度和音调匹配
  • 最大不适阈测试
更多 需考虑的检查

新兴检查

  • 耳声发射
  • 功能性MRI:
  • PET 扫描
  • 脑磁图描记术
更多 新兴检查

治疗流程

撰稿人

Medical Director Otologic/Neurotologic/Skull Base Surgery

Medical Director Wellness

Florida Hospital Celebration Health

Professort of Otolaryngology-Head and Neck Surgery

University of Central Florida

Board of Directors American Academy of Otolaryngology-Head and Neck Surgery

Celebration

FL

利益声明

MDS is a consultant for Acclarent; is the owner of Body Language Vitamins; and is involved in post-market studies for Envoy (non-compensated) and research for MicroTransponder, Inc (non-compensated), Auris Medical, and the National Institutes of Health. He receives royalties from 7 patents. He is an author of a number of references cited in this topic.

Dr Michael D. Seidman would like to gratefully acknowledge Dr Hamid Djalilian, Dr Alice Lee, Dr Vanessa Rothholtz, and Dr Sanaz Hamidi, the previous contributors to this topic. HD, AL, VR, and SH declare that they have no competing interests.

同行评议者展开全部内容

Clinical Adjunct Professor

Division of Neurotology

Department of Otolaryngology Head and Neck Surgery

University of Michigan

Ann Arbor

MI

Consulting Staff

Toledo ENT

Toledo

OH

利益声明

AB declares that he has no competing interests.

Consultant ENT Surgeon

Frimley Park Hospital

Portsmouth Road

Frimley

Surrey

UK

利益声明

AM declares that he has no competing interests.

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