首诊于耳科的颅内疾患临床分析

摘要

目的：探讨首诊于耳科的颅内疾患的临床特点、诊断及相关治疗经验。方法对2002-2015年我院门诊及病房收治的以听力下降、眩晕或耳鸣为首发症状的患者的临床特征进行分析，共发现27例颅内病变的患者。结果27例患者中，其中21例听神经瘤，2例颅内肿瘤，3例脑血管意外，1例脱髓鞘病变，这些患者当中，早期均无偏瘫、抽搐、意识障碍等神经系统的阳性症状体征，且主要症状均为耳部常见症状，经磁共振或高分辨率CT扫描后诊断明确，转诊相关专科处理。结论对于耳科门诊常见的听力下降、眩晕或耳鸣症状，除了要进行相关的听力、前庭学检查外，神经系统的体检也应注意涉及，必要时需行颅脑、内耳的磁共振或高分辨率CT检查，以免漏诊相关的颅内疾患，产生严重后果。%Objective To explore the clinical features, diagnosis and treatment of the initial diagnosis intracranial dis-eases related in the ear outpatient. Method Analyze the clinical characteristics of patients with hearing loss, vertigo or tinni-tus as the first symptoms of the patients with intracranial diseases in our hospital during the 2002-2015. Result In 27 pa-tients, there were 21 cases of acoustic neuroma, 2 cases of intracranial tumor, 3 cases of cerebral vascular accident and 1 case demyelinating disease. These patients, without nervous system positive location signs as paralysis, convulsions, con-sciousness disorder and with common symptoms of ear during early stage, after magnetic resonance imaging examination or high resolution CT scan, they were definite diagnosed and transferred to specialist department. Conclusion For patients with common hearing loss, vertigo or tinnitus symptoms in the otology clinic, not only taking correlative hearing and vestib-ular examination, but also physical examination of the nervous system. If necessary, brain and inner ear magnetic resonance or high resolution CT examination should be taken to avoid misdiagnosis of intracranial diseases and serious consequences.