Suzuki Toshihiro, Sakaguchi Hirofumi, Yamamoto Satoshi, Hisa Yasuo
Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
Auris Nasus Larynx. 2006 Sep;33(3):315-9. doi: 10.1016/j.anl.2005.11.010. Epub 2006 Jan 4.
We present a case of meningeal carcinomatosis with bilateral hearing loss secondary to a rectal adenocarcinoma. A 60-year-old woman developed progressive loss of hearing in the left ear 19 months after an abdominoperineal resection for an adenocarcinoma of the rectum. Three months after the onset of left hearing loss, she visited our hospital. Pure tone audiometry revealed profound sensorineural hearing loss in the left ear and mild sensorineural hearing loss in the right ear. Gadolinium-enhanced MRI revealed tumor in the left internal auditory canal and cerebellopontine angle and enhancement in the right internal auditory canal. Six days after the first examination, pure tone audiometry revealed profound loss of hearing in the right ear. DPOAE of the right ear were still detected 6 days after the first examination, but were clearly decreased 9 days after it, and reached noise level 10 days after it. Gadolinium-enhanced MRI revealed rapid growth of the tumor of the right internal auditory canal and cerebellopontine angle. We clearly demonstrate here the rapid course of hearing loss using pure tone audiometry, MRI, and DPOAE.
我们报告一例因直肠腺癌继发双侧听力丧失的脑膜癌病病例。一名60岁女性在因直肠腺癌接受腹会阴切除术后19个月,左耳听力逐渐丧失。左耳听力丧失3个月后,她前来我院就诊。纯音听力测试显示左耳为重度感音神经性听力损失,右耳为轻度感音神经性听力损失。钆增强磁共振成像显示左侧内耳道和桥小脑角有肿瘤,右侧内耳道有强化。首次检查6天后,纯音听力测试显示右耳听力重度丧失。首次检查6天后仍可检测到右耳的畸变产物耳声发射,但9天后明显下降,10天后达到噪声水平。钆增强磁共振成像显示右侧内耳道和桥小脑角的肿瘤迅速生长。我们在此通过纯音听力测试、磁共振成像和畸变产物耳声发射清楚地展示了听力损失的快速病程。