Zielińska-Bliżniewska Hanna, Michalska Joanna, Pietkiewicz Piotr, Miłoński Jarosław, Kuśmierczyk Krzysztof, Olszewski Jurek
Klinika Otolaryngologii i Onkologii Laryngologicznej II Katedry Otolaryngologii UM w Łodzi.
Otolaryngol Pol. 2011 Sep;65(5 Suppl):98-101. doi: 10.1016/S0030-6657(11)70716-8.
The aim of the work was to analyse sudden deterioration of hearing and/or vertigo occurrence as an early symptom of posterior cranial fossa tumours.
Among 1.394 people who reported vertigo and hearing impairment and were hospitalised at the Department of Otolaryngology and Laryngological Oncology Military Teaching Hospital in Lodz within the years of 2007-2010 twenty-seven patients were analysed. This group included 19 women aged 20-80 (mean age 45.7 years) and 8 men aged 25-73 (mean age 54.0 years) who had posterior cranial fossa tumours diagnosed on the basis of MRI. Each patient underwent a detailed interview, otorhinolaryngological and otoneurological examinations, pure tone, speech and impedance audiometry, suprathreshold tests (SISI, TDT), tinnitus pitch and frequency evaluation, auditory brainstem response (ABR), complete videonystagmography.
The studied material revealed: acoustic neuroma in 15 patients, cerebellar meningioma in 5 patients, cerebellar cyst in 4 patients and cerebellar angioma in 3 patients. Sudden vertigo was present in 27 patients, including mixed-type vertigo in 15 cases and central vertigo in 12 cases. In 19 patients dizziness was accompanied by tinnitus. In 22 patients hearing disorders were diagnosed in a form of: sensorineural hearing loss in 14 subjects, bilateral in 7 subjects, left-lateral in 5 subjects and right-lateral in 2 subjects respectively, as well as deafness in 8 patients, including left ear deafness in 5 cases, right ear deafness in 1 case and bilateral deafness in 2 cases (7.4%).
The early phase diagnosis of a posterior cranial fossa tumour as a cause of sudden hearing deterioration and/or vertigo is very seldom and often accidental because GPs, also otolaryngologists, who follow routine and economy, are not used to referring given patients for complete and objective audiological, otoneurological and imaging diagnostics.
本研究旨在分析听力突然下降和/或眩晕发作作为后颅窝肿瘤早期症状的情况。
在2007年至2010年间于罗兹军事教学医院耳鼻喉科及喉科肿瘤病房住院的1394例报告有眩晕和听力障碍的患者中,分析了27例患者。该组包括19名年龄在20至80岁(平均年龄45.7岁)的女性和8名年龄在25至73岁(平均年龄54.0岁)的男性,他们均经磁共振成像(MRI)诊断为后颅窝肿瘤。每位患者均接受了详细的访谈、耳鼻喉科及耳神经科检查、纯音、言语及声阻抗测听、阈上试验(短增量敏感指数试验、甘油试验)、耳鸣音调及频率评估、听性脑干反应(ABR)、完整的视频眼震图检查。
研究资料显示:15例为听神经瘤,5例为小脑脑膜瘤,4例为小脑囊肿,3例为小脑血管瘤。27例患者出现突然眩晕,其中15例为混合型眩晕,12例为中枢性眩晕。19例患者头晕伴有耳鸣。22例患者被诊断有听力障碍,表现为:14例为感音神经性听力损失,其中7例为双侧,5例为左侧,2例为右侧;8例为耳聋,其中5例为左耳耳聋,1例为右耳耳聋,2例为双侧耳聋(7.4%)。
后颅窝肿瘤作为听力突然下降和/或眩晕原因的早期诊断非常少见且往往是偶然的,因为遵循常规和经济性原则的全科医生以及耳鼻喉科医生不习惯将特定患者转介进行全面客观的听力学、耳神经学及影像学诊断。