Evolution of pediatric sudden deafness during the past two decades 小兒突發性耳聾在過去 二十年來的演進 各位醫師大家好，現在報告小兒的突發性耳聾過去二十年來的演進 張邦彥 楊怡和 臺大醫院耳鼻喉部
Sudden deafness in children SD in children is rare Sudden deafness in children Viral infection Vascular insufficiency Autoimmune disorders
Patients (1996-2015) Group B Group A (2006-2015) (1996-2005) Case no: 25 Gender: 7 M, 18 F Age: 10 ± 3 Y R / L= 11 / 14 Group B (2006-2015) Case no. 5 Gender: 3 M, 2F Age: 11 ± 4 Y R / L = 3/2 p > 0.05
Pediatric vs. overall SD 7 % 2 % p<0.01 1996-2005 2006-2015
Methods Otoscopy Audiometry Caloric test cVEMP test after 2000 oVEMP test after 2008 方法：所有的病人都接受耳鏡、聽力、caloric test，在2000年之後開始新增cvemp，在2008年之後的病人都接受ovemp的檢查
Clinical manifestation (n=30) 100 100 57 (%) 40 10 Aural fullness Tinnitus Vertigo Hearing loss
Types of audiogram (n=30) 100 (%) 57 33 10
Mean hearing levels (n=30) 10 20 30 40 Hearing Level (dB) 50 60 70 80 90 77% 100 110 500 1000 2000 3000 Frequency ( kHz )
Hearing outcome : improved : unchanged 12% 12% 37 % 88% 63 % 88%
Declining sequence of inner ear deficits MHL 93% : abnormal : normal 38% Caloric 20% cVEMP p<0.05
From audiological perspective 100 57 Children (%) 33 10 Adults 49 100 26 13 5 7 (%)
Temporal bone histopathology Measles Loss of Corti’s organs Relatively intact of vestibular hair cells
From vestibular perspective damage Cochlear damage
From demographic perspective + = 2005 1994 11 95% MMR vaccination year mean age of pediatric SD 1996-2005 2006-2015 7% 2%
Conclusion Prevalence of pediatric SD has decreased significantly during the past 20 years. Global MMR vaccination policy may be responsible for the decline in the prevalence of pediatric SD. 我們結論是，
World Heritage: Segovia, Spain 這是世界文化遺產。