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題 名 | 聽神經瘤的形態與耳科學檢查結果之關係=Correlations between Morphology of Acoustic Neuroma and Otological Manifestations |
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作 者 | 吳辰龍; 林鴻清; 徐銘燦; 張克昌; | 書刊名 | 中華民國耳鼻喉科醫學會雜誌 |
卷 期 | 33:4 1998.08[民87.08] |
頁 次 | 頁9-16 |
分類號 | 416.81 |
關鍵詞 | 聽神經瘤; Acoustic neuroma; |
語 文 | 中文(Chinese) |
中文摘要 | 背景:聽神經瘤的形態會因為腫瘤的位置與腫瘤的大小而有所不同,它的 形態與各種耳科學檢查結果的關係,是本研究探討的主題。方法:21 名聽神經瘤的患者,依 其電腦斷層或磁振影像上腫瘤的位置,分為外側型腫瘤 (3 例,14.3 % )、中間型腫瘤 (9 例,42.8 % ) 與內側型腫瘤 (9 例, 42.8 % ) 三組。又依腫瘤的大小,分為小腫瘤 (2 例,9.5 % ),中腫瘤 (10 例, 47.6 % ) 與大腫瘤 (9 例,42.9 % ) 三組。患者之臨 床症狀及各種耳科學檢查的結果均加以記錄。結果: 經分析發現具顯著差異者如下:1) 外側 型聽神經瘤多為小腫瘤,內側型聽神經瘤則多為大腫瘤。 2) 身體不平衡與頭痛的症狀較常 出現在大聽神經瘤,少出現在小聽神經瘤。 3) x光 Stenvers 投影的結果在內側型聽神經 瘤全部正常,而在外側型與中間型聽神經瘤則多為不正常。而各種耳科學檢查對診斷聽神經 瘤的靈敏度分別如下: 聽反射閾值檢查 85 % (其中 55 %為聽反射消失, 30 %為聽反射 閾值異常 ); 聽反射衰退檢查 15 %; x光 Stenvers 投影 52.6 %;聽性腦幹反應檢查 100 %。結論: 我們認為,某些症狀的出現 (例如身體不平衡、頭痛、突發性耳聾等 ),似 乎可大致猜測聽神經瘤的形態;此外,最好同時施行多種的耳科學檢查,才能增加診斷聽神 經瘤的靈敏度,尤其是聽性腦幹反應檢查。 |
英文摘要 | Background:Twenty-one patients with acoustic neuroma were studied to determine whether different types of neuroma could be correlated with specific signs, symptoms or otological manifestations. Methods:Based on CT or MRI results, 21 cases of acoustic neuroma could be divided into three groups, either by size (small; 9.5%, medium: 47.6%, and large: 42.9%) or by site of origin of the tumor (lateral: 14.3%, intermediate: 42.8%, and medial: 42.8%). Relations were tstudied between the size and the site of origin of the tumor and clinical and otological findings. Results: Patients with lateral neuromas generally had smaller tumors while patients with medial neuromas had larger tumors. Unsteadiness was noted more often in patients with large neuromas than those with small or medium neuromas. High tome hearing loss was the most frequent presentation in pure tone audiometry of these 21 patients. The sensitivity of acoustic reflex threshold (ART) test was 85%, and more than half of the abnormal group were presented with the type IV ART pattern. Stenver's projection of X-ray was noted more sensitive in patients with lateral neuromas, while in patients with medial neuromas it showed a 100% false negative rate, The sensitivity of the brainstem evoked potentials (BAEPs) was 100%: however, abnormalities in the BAEPs did not seem to be ralated to either the size or the site of origin of the tumor. Conclusions: Some specific otological manifestations seem to be correlated with specific morphology of acoustic neuromas. In addition, combining 2 or more otological data can improve the senditivity rate in detecting acoustic tumors: especially when BAEPs abnormalities being considered insignificant at the presence of profound hearing loss. |
本系統中英文摘要資訊取自各篇刊載內容。