半规管填塞及人工耳蜗植入共同治疗迟发性膜迷路积水1例

Triple semicircular canal occlusion with cochlear implantation for delayed endolymphatic hydrops:a case report

1病例报告 患者,女,46岁。自幼左耳全聋,8年前右耳出现波动性听力下降及耳鸣,4年前出现反复发作性眩晕,视物旋转、恶心呕吐,每次持续0.5h左右,发作时右耳耳鸣、听力下降加重,发作后耳鸣略缓解,听力稍恢复,2~3个月发作一次。治疗期间曾口服甲磺酸倍他司汀,地塞米松鼓室内注射等,初始效果较好,之后渐渐无法控制眩晕发作。入院前2个月,患者每日发作眩晕,右侧耳呈重度感音神经性聋,严重影响工作生活,药物无法控制。

Summary A 46-year-old female with profound sensorineural hearing loss in her left ear from childhood developed tinnitus and fluctuating hearing loss on the right side 8 years ago. Four years later, paroxysmal episodes of rotatory vertigo occurred with gradually increased frequency, lasting from half an hour to 2 hours and accompanied with nausea and vomiting. Audiometric test revealed severe sensorineural hearing loss in both of her ears. The tympanograms showed type A on both sides. The threshold of auditory brainstem response was 97 dBnHL in her right ear while no waves could be educed on her left side. Weakened right-sided vestibular function was confirmed on caloric testing and vestibular-evoked myogenic potential. A normal cochlear morphology and clearness cerebellopontine angle were shown in the MR imaging scan. She was diagnosed with Delayed Endolymphatic Hydrops.