洪偉誠 鄭博文 楊怡和* 亞東醫院耳鼻喉科 台大醫院耳鼻喉部* Rethinking of sudden deafness in young adults aged 20-39 years 20-39歲青壯年突發性耳聾的再探討 洪偉誠 鄭博文 楊怡和* 亞東醫院耳鼻喉科 台大醫院耳鼻喉部*
Outbreak of Measles March, 2018
Young adults SD (2011-2016) Case no.: 33 /182 (18%) Sex : M / F = 16 / 17 Age : 20 – 39 (31) Y R / L = 9 / 24
Prevalence of SD by age (n=182) 50-59 60-69 70-79 80-89 10 25 (%) 26 16 20-29 0-19 2 2 6 30-39 12 (year-old)
Methods Audiometry oVEMP test cVEMP test Caloric test Serologic tests: Mumps, Measles, Rubella, Varicella-zoster virus
Clinical manifestation (n=33) 100 61 100 (%) 91 67 61 45 Hearing loss Tinnitus Fullness Vertigo Nausea/vomiting 6 6
Types of audiogram (n=33 ears) 15 15 11 7
Mean hearing level Hearing Level (dB) Frequency ( kHz ) -10 10 20 30 10 20 30 40 50 60 70 80 90 100 110 : normal : abnormal 0.5 1.0 2.0 3.0 Frequency ( kHz ) 8
Abnormal ENG results 100 (%) Pursuit Saccade OKN 9% 9% : abnormal Pursuit Saccade OKN
Vestibular test abnormality 100 62 (%) 45 24 cVEMP oVEMP Caloric
Sequence of inner ear deficits : normal : abnormal Audiometry oVEMP 45% cVEMP 24% caloric p<0.001
Serological Profiles : (-) : (+) IgM Mumps Measles Rubella VZV IgG
Outcome of hearing : improved : unchanged 67 %
Prevalence of SD 4% Aged 0-19 Y <
Conclusion Prevalence of SD in young adults is higher than children, probably due to declining viral antibodies beyond previous vaccination coverage. A combination vaccine called MMRV that may help prevent the reactivation of these causal agents. 15
世界文化遺產: 洛陽 龍門石窟 16