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本文分析了25例手术证实听神经瘤的临床表现。以听力减退、不稳感和耳鸣为最常见的症状。自发性眼震、角膜反射迟钝或消失、面部感觉减退和视神经乳头水肿为重要的体征。听力学检查表现为感音神经性聋,自描测听为Ⅲ和Ⅳ型,脑干电位Ⅴ波潜伏期延长或Ⅱ～Ⅴ波消失。前庭功能检查提示耳蜗后病变。X 线平片和断层摄片发现内听道扩大和骨质吸收,脑池造影和 CT 摄片可显示出肿瘤的大小、形态和位置。作者提出要熟悉听神经瘤的各种不同的临床表现,对怀疑听神经瘤的病人要作全面检查,并提出进行诊断的检查步骤。
This article analyzes the clinical manifestations of 25 cases of acoustic neuroma confirmed by surgery. With hearing loss, instability and tinnitus as the most common symptoms. Spontaneous nystagmus, slow or disappearance of corneal reflex, facial sensation and papilledema are important signs. Hearing test showed sensorineural deafness, self-reported to listen to type Ⅲ and Ⅳ, brain stem potential Ⅴ wave latency or disappeared Ⅱ ~ Ⅴ wave. Vestibular function tests suggest post-cochlear lesions. X-ray and tomography found that the expansion of the internal auditory canal and bone absorption, cisterns and CT imaging can show the size, shape and location of the tumor. The authors propose to be familiar with the various clinical manifestations of acoustic neuroma, to conduct a comprehensive examination of patients suspected of acoustic neuroma and to propose diagnostic testing steps.