产后眩晕与上半规管裂综合征
Postpartum vertigo and superior semicircular canal dehiscence syndrome.
作者信息
Ogutha Jacqueline, Page Nathan C, Hullar Timothy E
机构信息
From the Departments of Obstetrics and Gynecology, Otolaryngology-Head and Neck Surgery and Anatomy and Neurobiology, Washington University School of Medicine, St. Louis, Missouri.
出版信息
Obstet Gynecol. 2009 Aug;114(2 Pt 2):434-436. doi: 10.1097/AOG.0b013e3181ae8da0.
BACKGROUND
Superior semicircular canal dehiscence is a recently described cause of imbalance, hearing loss, and tinnitus. Symptoms may begin after abrupt changes in intracranial or middle ear pressure.
CASE
This patient presented with a 6-year history of imbalance, hearing loss, and pulsatile tinnitus beginning when she was pushing during labor. A temporal-bone computed tomography scan showed a dehiscence of the superior semicircular canal. Surgical repair of the dehiscence through the middle cranial fossa resulted in immediate resolution of the patient's symptoms, and she returned to full activity within 3 weeks.
CONCLUSION
Superior semicircular canal dehiscence is recognized increasingly as a cause of multiple otologic symptoms. Obstetricians and gynecologists with patients complaining about postpartum vertigo should inquire about symptom onset and focus their questions around events during the second stage of labor. Patients with symptoms of dehiscence should be referred to a neurootologist for treatment, including possible surgical repair.
背景
上半规管裂是一种最近才被描述的导致平衡失调、听力丧失和耳鸣的病因。症状可能在颅内或中耳压力突然变化后出现。
病例
该患者自分娩时用力起，有6年平衡失调、听力丧失和搏动性耳鸣病史。颞骨计算机断层扫描显示上半规管裂。通过中颅窝进行裂孔的手术修复使患者症状立即得到缓解，她在3周内恢复了正常活动。
结论
上半规管裂越来越被认为是多种耳科症状的病因。对于有产后眩晕症状的患者，妇产科医生应询问症状发作情况，并围绕第二产程中的事件重点提问。有裂孔症状的患者应转诊至神经耳科医生处进行治疗，包括可能的手术修复。
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