Ulug Tuncay, Ulubil S Arif
Department of Otolaryngology, Istanbul University, Faculty of Medicine, Istanbul, Turkey.
J Otolaryngol. 2006 Dec;35(6):380-3. doi: 10.2310/7070.2006.0069.
In this case presentation, three cases of labyrinthine concussion in the opposite ears of patients who had unilateral traumatic temporal bone fractures with facial paralysis are reported. The first patient was a 30-year-old male who had a right-sided longitudinal temporal bone fracture and labyrinthine concussion showing pure sensorineural hearing loss with a characteristic notch of 60 dB at 4000 Hz on the left side. The second patient was a 42-year-old male who had a right-sided traumatic facial paralysis owing to a mixed-type temporal bone fracture and labyrinthine concussion, demonstrating pure sensorineural hearing loss reaching its peak of 50 dB at 4000 Hz on the left. The third patient was a 19-year-old male who had a left-sided mixed-type temporal bone fracture and a right labyrinthine concussion exhibiting pure sensorineural hearing loss reaching 60 dB at 4000 Hz. For their facial paralyses, all three patients underwent middle cranial fossa or combined approach operations. The labyrinthine concussion in these patients was managed expectantly. At their 1-year follow-up, it was observed that the hearing loss owing to labyrinthine concussion persisted. Although labyrinthine concussion is not a rare complication of head injuries, it has rarely been reported in the medical literature. The main symptoms of labyrinthine concussion are hearing loss, tinnitus, and dizziness. The diagnosis mainly relies on audiometric tests, which reveal characteristic tracings reminiscent of acoustic trauma.
在本病例报告中,报道了3例单侧外伤性颞骨骨折伴面瘫患者对侧耳发生迷路震荡的病例。首例患者为一名30岁男性,右侧颞骨纵行骨折并伴有迷路震荡,表现为左侧单纯感音神经性听力损失,在4000Hz处有特征性的60dB切迹。第二例患者为一名42岁男性,因混合型颞骨骨折和迷路震荡导致右侧外伤性面瘫,左侧表现为单纯感音神经性听力损失,在4000Hz处达到50dB的峰值。第三例患者为一名19岁男性,左侧混合型颞骨骨折,右侧迷路震荡,表现为单纯感音神经性听力损失,在4000Hz处达到60dB。针对他们的面瘫,所有3例患者均接受了中颅窝手术或联合入路手术。这些患者的迷路震荡采取了观察等待的处理方式。在1年随访时,发现迷路震荡所致的听力损失持续存在。尽管迷路震荡并非头部损伤的罕见并发症,但在医学文献中鲜有报道。迷路震荡的主要症状为听力损失、耳鸣和头晕。诊断主要依靠听力测试,其显示出类似于声损伤的特征性曲线。