Scapa Victor I, Friedland David R
Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
Ear Nose Throat J. 2009 Mar;88(3):E14-9.
Sudden sensorineural hearing loss (SSNHL) is a rare otologic emergency. Recurrence of this pathology is extremely rare, and its incidence remains unknown. We report the case of a previously healthy 28-year-old man with normal findings on bilateral ear examination who presented with severe unilateral SSNHL. Audiometry demonstrated a pure-tone average of 70 dB and a speech discrimination score of 0% in the affected ear. The patient was treated within hours of the onset of symptoms with an intratympanic injection of dexamethasone and then started on a tapered course of oral prednisone. He experienced a full recovery based on repeat audiometric testing 7 days later. However, 1 year later, the patient experienced a repeat episode of SSNHL in the same ear. Management again included an intratympanic injection and an oral steroid course with good results. A complete metabolic and radiographic evaluation failed to identify a cause of the hearing loss. This case represents a highly unusual instance of recurrent SSNHL of unknown etiology.
突发性感音神经性听力损失(SSNHL)是一种罕见的耳科急症。这种病症的复发极为罕见,其发病率尚不清楚。我们报告一例既往健康的28岁男性病例,双侧耳部检查结果正常,却出现了严重的单侧SSNHL。听力测试显示患耳纯音平均听阈为70分贝,言语识别率为0%。患者在症状发作数小时内接受了鼓室内注射地塞米松治疗,随后开始口服泼尼松逐渐减量疗程。7天后重复听力测试显示他已完全康复。然而,1年后,该患者同一耳再次出现SSNHL发作。治疗再次包括鼓室内注射和口服类固醇疗程,效果良好。全面的代谢和影像学评估未能确定听力损失的原因。该病例代表了病因不明的复发性SSNHL的一个非常罕见的实例。