急性低音障害型感音難聴の臨床像　続報

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  • Further clinical observations on Acute Low-Tone Sensorineural Hearing Loss.

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Acute low-tone sensorineural hearing loss (ALHL) appears to be one of more common otologicdisorders than previously thought and is characterized clinically by the features that: 1) the onset isacute or sudden, 2) the etiology remains obscure, and 3) the hearing loss is mild to moderate andusually unilateral.<BR>Although it is generally known that complete recovery of the hearing losses within a few weekscan be expected in majority of the patients, it has been also known that recurrence or even aggravationof this condition can occur, or clinical signs characteristic of Meniere's disease may developin selected patients.<BR>We retrospectively studied 137 patients with this disorder since late 1983 over a period of 8 years and could observe similar results with regard to the clinical symptoms and the prognoses tothose reported by other investigators in Japan.<BR>In addition, our clinical observations on ALHL further indicated following two clinical findings: Firstly, in patients with unilateral involvement the sum of the hearing level in the lower frequencyrange (500, 250 and 125Hz) was worse than that in the higher frequency range (2, 4 and 8KHz) even inthe unaffected ear and the difference was statistically significant. In other words, even when anear was unaffected (better hearing ear), the lower frequency range of the unaffected ear was alsosomewhat impaired, although the sum of the hearing losses did not reach the value of the lossesdetermined by our diagnostic critera. Thus, the tendency toward bilateral involvement or bilater -ality of the disease may be of some significance to explain its possible pathogenesis or etiology. Secondly, the positive Schellong test results which were thought to be indicative of orthostaticdysfunction were found in 46.3% of the patients with this disorder, and patients with hypotensionwere also found in 37.6%. These percentages were significantly higher than those of the controlgroup. More than one-third of the patients with ALHL seemed to have a systemic condition suggestiveof autonomic imballance or insufficient blood circulation.

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