突发性聋的诊断和治疗指南(历程).docVIP

2012 AAO-HNSF 突发性听力丧失临床实践指南 在美国突发性感觉神经耳聋(SSNHL)的发病率约为5～20/10万人，每年新发病例在4000例左右。该指南对SHL成年患者的诊断、治疗和随访做出了相应推荐，希望医生能更精确的做出诊断、快速介入治疗、减少不必要的治疗方案改动、避免不必要的实验室检查和影像检查，从而改善患者听力和康复结果。快速和准确做出诊断的重要性：①将感觉神经性耳聋与传导性耳聋相鉴别；②双侧SSNHL、复发SSNHL或局部神经病学改变等症状表明患者存在潜在病因，应采取对症治疗；③对特发性突发感觉神经耳聋(ISSNHL)的诊断以听力测验结果为准，即3次连续测量听力丧失超过30分贝，根据病史和体格检查排除其他病因。应避免的不必要检查和治疗包括： ①常规脑CT对诊断没有必要，且让患者接受了离子辐射。②不推荐采用常规、无靶向、实验室检查；③不需服用的药物包括：抗病毒药、溶栓药、血管舒张药、血管活性药或抗氧化药。对ISSNHL的初始治疗应包括皮质类固醇激素 ①激素给药方式可为系统性的或通过鼓室内设备递送。②可给予高压氧疗法。随访和咨询的重要性 ①医生应当告知ISSNHL患者该病的自然病程、治疗的利弊和目前疗效中的不足之处；②医生应在确诊ISSNHL后6个月内对患者进行随访；③医生应建议听力恢复不完全的患者接受听力辅助设备。 AAO-HNSF clinical practice guideline: Sudden hearing loss March 1, 2012 in Surgery On March 1, 2012 American Academy of Otolaryngology the American Academy of Otolaryngology-Head and Neck Surgery Foundation published a new Clinical Practice Guideline on Sudden Hearing Loss (SHL). This guideline is published as a supplement to Otolaryngology–Head and Neck Surgery. A sudden loss of hearing is a frightening symptom that most often prompts urgent medical care. Current diagnosis and treatment plans vary greatly. This guideline provides evidence-based recommendations for the diagnosis, management, and follow-up of adults who present with SHL. Prompt, accurate recognition and management of sudden sensorineural hearing loss (SSNHL), a subset of SHL, may improve hearing recovery and patient quality of life. SSNHL affects 5 to 20 per 100,000 population, with about 4,000 new cases per year in the United States. The purpose of this guideline is to provide all clinicians who may encounter patients with SHL with evidence-based recommendations for diagnosis, counseling, treatment, and follow-up. By focusing on opportunities for quality improvement, the guideline should improve diagnostic accuracy, facilitate prompt intervention, decrease variations in management, reduce unnecessary tests and imaging procedures, and improve hearing and rehabilitative outcomes for affected patients. We are p