感音神经性听力损失的病因和康复

Seung Hwan Lee
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摘要

听觉是一种特殊的感觉,我们通过探测振动来感知声音。听力能力对我们进行互动、沟通和社交非常重要。人的耳朵是由外耳、中耳和内耳组成的外围感觉器官。外耳通过外耳道将声能集中到鼓膜上。中耳通过听骨链放大声音能量,听骨链将声音振动传递到内耳。内耳包括发生声能机电转导的耳蜗。人类感知到声音的振动是振动机械力的短暂听觉信号,通过外耳和中耳传递,在那里它们被转导成内耳的神经信号,通过听神经到达听觉皮层的中央听觉系统,在那里信号被处理、解释并传递给感知处理。理解中枢神经系统中的中枢听觉处理对于理解声音信息如何被区分和分析以实现良好的交流至关重要。外周或中枢听觉通路的任何单一问题都可能导致听力损伤。传导性听力损失是指由于不适当的机械传动而导致的听力损失。可引起传导性听力损失的情况有外耳道异物阻塞、鼓膜穿孔、中耳积液、听骨破坏等。根据传导性听力损失的具体原因,药物或手术治疗可以恢复听力。感音神经性听力损失是指因毛细胞损伤或神经变性等内耳问题引起的听力损失。与传导性听力损失不同,感音神经性听力损失通常是永久性的。感音神经性听力损失分为先天性和后天两种。先天性听力损失可能由先天性异常、染色体综合征或先天性感染(如风疹或巨细胞病毒)引起。获得性感音神经性听力损失可能有许多病因,包括
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Etiology and Rehabilitation of Sensorineural Hearing Loss
Hearing is a special sense by which we perceive sound by detecting vibrations. Hearing ability is important for us to be able to interact, communicate and socialize. Sound is captured by the human ear which is a peripheral sensory organ composed of the external ear, middle ear and inner ear. The external ear serves to focus sound energy through the external auditory canal toward the tympanic membrane. The middle ear amplifies the sound energy via the ossicular chain which transfers sound vibrations to the inner ear. The inner ear includes the cochlea where mechano-electrical transduction of sound energy takes place. Humans perceive the vibrations of sound as transient auditory signals of vibratory mechanical forces transmitted through the external ear and middle ear, where they are transduced to neural signals in the inner ear passing via the auditory nerve to the central auditory system of the auditory cortex where the signal is processed and interpreted and passed on for perceptive processing. Understanding the central auditory processing in the central nervous system is essential to understanding how the sound information is discriminated and analysed to allow good communication. Any single problem in the peripheral or central auditory pathway may cause hearing impairment. Conductive hearing loss is defined as the hearing loss due to inappropriate mechanical transmission. Conditions that can cause conductive hearing loss are foreign body obstruction of the external auditory canal, perforation of the tympanic membrane, middle ear effusion, the destruction of ossicles, etc. Depending on the specific cause of conductive hearing loss, medical or surgical treatment can restore hearing. Sensorineural hearing loss refers the hearing loss caused by inner ear problems such as hair cell damage or neural degeneration. Unlike the conductive hearing loss, sensorineural hearing loss is usually permanent. Sensorineural hearing loss is divided into congenital and acquired. Congenital hearing loss may be caused by a congenital anomaly, a chromosomal syndrome or a congenital infection such as rubella or cytomegalovirus. Acquired sensorineural hearing loss might have numerous etiologic causes, including
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