结构处理 & 耳朵的功能
Ear care, or otology, specifically treats the structure 和 function of the ear. Ear conditions include hearing 和 balance disorders, 耳病耳朵的损伤或疾病, 肿瘤, 以及其他（见下文）. Our specialists treat both adult 和 pediatric patients. 病人 are also seen by neurotology specialists, who specifically care for the nerves that connect the ear 和 brain in surgery.
耳朵的条件
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我的耳朵是如何听到声音的?
耳朵分为三个部分：外耳、中耳和内耳. Each part performs an important function in the process of hearing. Sound waves pass through the canal of the external ear 和 vibrate the eardrum, which separates the external ear from the middle ear. The three small bones in the middle ear (hammer or malleus, 铁砧或砧木, 马镫（镫骨）就像一个变压器，将声音振动的能量传递到内耳的液体中. Vibrations in this fluid stimulate the delicate nerve fibers. 然后，听觉神经将声音脉冲传递到大脑，在那里它们被解释为可理解的声音.
What Are the Different Types of Hearing Loss?
The external ear 和 the middle ear conduct sound; the inner ear receives it. 如果外耳或中耳有困难，就会发生传导性听力损失. 如果问题出在内耳，则会导致感觉神经性听力损失（SNHL）或神经性听力损失. When there is some difficulty in both the middle 和 inner ear, a combination of conductive 和 sensorineural impairment exists, 叫做混合性听力损失.
- 传导性听力损失 - Any disease affecting the ear canal (external ear), 耳膜, 中耳间隙, 或者，三个小耳骨可能会干扰声音向内耳的传输，从而导致传导性听力损失. 这种传导性听力障碍可能是由于鼓膜穿孔（孔）造成的, partial destruction or fixation of one or all of the three little ear bones, or scar tissue around the ear bones or in the 耳膜. Other causes of conductive hearing losses include wax in the ear canal, 中耳积液或感染, or any other process that would prevent sound from reaching the inner ear.
- Sensorineural Hearing Loss (inner ear hearing loss) - As described above, sensorineural hearing loss is an inner ear hearing loss. The inner ear loss can occur in the cochlea, 耳蜗或听神经, 脑干, 或者是听觉皮层. The auditory cortex is the region of the brain in which sound is heard. For most cases of sensorineural hearing loss, 包括突发性SNHL, the abnormality is within the cochlea itself. 对于大多数SNHL病例，包括突发性SNHL，外耳道和中耳正常.
什么是突发性感音神经性听力损失?
突发性感音神经性听力损失（SSNHL）被定义为三天或更短时间内听力下降大于或等于20分贝，没有任何可识别的原因.
感音神经性听力损失症状
Very few symptoms are usually experienced in patients with sudden SNHL. 显然，听力损失（绝大多数只在一只耳朵）是主要症状. The patient may also experience tinnitus or ringing in the ear. Occasionally, fullness in the involved ear is encountered. 疼痛很少伴随. 在某些情况下，不平衡或真正的旋转（眩晕）可能与突发性SNHL有关.
Is it common to suddenly lose your hearing?
Approximately 4,000 cases of sudden SNHL occur annually in the United States. 听力损失 from aging (presbycusus) 和 noise exposure are relatively common. There types of losses occur gradually over many years. 由感觉神经性（内耳）引起的突发性听力损失相对不常见. 导电性突然损失（见上文）比突发性内耳损失更常见. Examples of sudden conductive hearing losses include wax in the ear canal, 中耳腔积液或感染, 耳朵的慢性感染, 或中耳骨异常.
突发SNHL的原因
By definition the exact cause of sudden SNHL is literally unknown cause. 目前的研究正在确定突发性听力损失的原因以及潜在的治疗方法. Some of the proposed causes are listed below. The most commonly proposed causes of sudden SNHL include:
- 内耳病毒感染；
- blood flow abnormalities to the inner ear, 和
- 内耳流体力学问题导致耳蜗细膜撕裂.
病毒感染
也许最常见的解释突发性听力损失的理论是病毒感染. 研究人员在突发性SNHL患者中发现了病毒感染的证据, 这就是为什么怀疑病毒感染. A viral infection can cause inflammation of the inner ear or auditory nerve. 内耳结构和相关血管的炎症会导致听力丧失. 通常不会遇到疼痛、发烧、肌肉痉挛或其他病毒性疾病的症状. 偶尔，上呼吸道感染的迹象可能先于突发SNHL的发作.
耳蜗膜撕裂
耳蜗或内耳是由细小的膜构成的，膜中含有充满液体的空间. It is the movement of the fluid in these spaces that creates sound. Particular electrolytes are in these fluid filled spaces. 这种电解质的主动储存在这些由细膜隔开的充满液体的空间中产生不同的电荷（+或-）. 电荷差, 或潜在的, 在空间之间可以产生神经冲动，就像电池的正极和负极可以感应电流一样.
A tear in the fine delicate membranes can lead to a mixing of the fluid, 一种潜在的损失, 和 an inability to generate a nerve impulse. This inability to generate a nerve impulse leads to a hearing loss. 膜撕裂可由先前存在的缺陷（可能是遗传性的）和间隙中过多的液体引起，如梅尼埃氏病（见梅尼埃氏病部分）。.
血流异常
Another potential cause for hearing loss is abnormal blood flow to the cochlea. 严重的高血压可能导致内耳出血，从而导致听力丧失. 动脉硬化引起的血流不畅可能导致灌注不足或血液流入耳蜗. These mechanisms may be described as a stroke of the inner ear. This cause is more commonly found in the elderly, 但也可能与年轻人服用避孕药有关.
耳蜗内膜撕裂
A tear in one of the fine membranes that makes up the inner ear. May be the cause of hearing loss in Meniere’s disease.
突发SNHL的其他潜在原因
- Bacterial infection, such as Otitis media, syphilis
- 血管闭塞（源自中风）
- Vasculitis or inflammation of the blood vessels
- Meniere’s disease or inner ear fluid build up
- Labyrinthitis, (viral or bacterial inner ear infection)
- Meningitis (viral or bacterial infection of brain lining)
- Medical disorders, such as diabetes, hypo- or hyperthyroidism
- 遗传性疾病, 如内耳遗传性听力损失, 亚瑟综合征, 华尔登布尔氏综合征
- Low levels of oxygen (hypoxia) (from stroke)
- 药物治疗s, such as antibiotics, (termed ototoxic medications)
- Malignant neoplasm (肿瘤 or cancer of the ear)
- Benign neoplasms (肿瘤), such as acoustic neuroma, meningioma
- 自身免疫性听力损失：免疫系统紊乱会影响内耳，就像类风湿关节炎是一种影响关节的免疫系统紊乱一样
- 胆脂瘤或慢性中耳感染也可导致中耳晚期失聪
- 耳硬化症 or fixation of hearing bones, can also cause an inner ear loss
- Hypertension, which may cause bleeding in the inner ear or brain
听力损失的治疗
诊断测试
对来办公室抱怨听力损失的病人的标准评估是进行正式的听力测试. 作为评估的一部分, 大发娱乐进行广泛的病史和身体检查，以确定是否可以找到病因，以指导评估和治疗. 大发娱乐做的第一个测试是正式的听力测试，以确定听力损失的类型和程度. If a sensorineural loss is confirmed, we may get a MRI scan of the head. 这样做的主要目的是为了排除突发性听力损失的其他原因（肿瘤、中风）。.
SNHL治疗
药物治疗
The most common medications used are steroids (like prednisone), which are powerful anti-inflammatory agents. 它通常是口服的，但在某些情况下可以直接注射到中耳. Vasodilator medications may also be prescribed. 通常可以在短时间内给予多种药物来治疗所提出的原因. 越早开始治疗，听力改善的可能性就越大.
Prednisone is the mainstay in the treatment of sudden SNHL. 强的松通常在10-14天的时间内逐渐减少剂量. 就像所有药物一样, steroids have certain potential side effects that include mood elevation, 失眠, 骨骼和髋关节问题, 还有胃部刺激.
中耳类固醇注射
地塞米松灌注是一个相对简单的程序，在办公室设置. 本质上，类固醇溶液通过受影响耳朵的鼓膜直接注射到中耳空间. 初步研究表明，跨鼓室疗法在治疗突发性听力损失患者中可能具有积极作用. 全国各地的几位医生目前正在研究类固醇灌注对恢复听力的潜在有益作用. 其影响目前尚不清楚.
助听器放置
助听器, such as a CROS or bone-anchored hearing aid (BAHA) may be placed.
耳蜗植入设备
耳蜗植入设备 may be used in the event of a bilateral SNHL.
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听力损失恢复
回收率在5-90%之间, 但总体可接受的恢复率约为60%（三分之二的患者有望在一定程度上恢复听力）。. In some patients, the hearing loss will recover spontaneously without therapy.