突发性感音神经性听力损失的病毒病因学：历史发展与当前证据

文献信息

中文摘要

背景： 突发性感音神经性听力损失（SSNHL）是一种耳科急症，其病因复杂且异质，大多数病例仍无法解释，因此被归类为特发性。病毒感染长期以来被认为是SSNHL的重要潜在病因；然而，病毒相关听力损失的机制以及病毒感染与SSNHL之间的因果关系尚未完全阐明。当前证据提示，病毒可能通过直接侵入内耳、潜伏病毒再激活、免疫介导损伤以及细胞应激和炎症反应等途径诱发急性听力损失。本综述描述了与SSNHL相关的主要病毒及其流行病学和临床特征；总结了来自血清学检测、分子病毒学、影像学、颞骨组织病理学和动物研究的证据；并讨论了病毒相关SSNHL在致病机制、病因学诊断和抗病毒治疗方面的最新进展。本综述旨在系统阐明当前围绕SSNHL病毒病因学的证据与争议，并为病毒相关SSNHL的病因识别、患者分层和靶向治疗提供参考。

英文摘要

Sudden sensorineural hearing loss (SSNHL) is an otological emergency with complex and heterogeneous etiologies, and most cases remain unexplained and are therefore classified as idiopathic. Viral infection has long been considered an important potential cause of SSNHL; however, the mechanisms underlying virus-associated hearing loss and the causal relationship between viral infection and SSNHL have not been fully elucidated. Current evidence suggests that viruses may induce acute hearing loss through direct invasion of the inner ear, reactivation of latent viruses, immune-mediated injury, and cellular stress and inflammatory responses. This review describes the major viruses associated with SSNHL and their epidemiological and clinical characteristics; summarizes evidence from serological testing, molecular virology, imaging, temporal bone histopathology, and animal studies; and discusses recent advances in the pathogenic mechanisms, etiological diagnosis, and antiviral treatment of virus-associated SSNHL. This review aims to systematically clarify the current evidence and controversies surrounding the viral etiology of SSNHL and to provide a reference for etiological identification, patient stratification, and targeted treatment of virus-associated SSNHL.