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[脑脊液穿刺后内耳听力损失:一种未得到充分认识的并发症?]

[Inner ear hearing loss following cerebrospinal fluid puncture: a too little appreciated complication?].

作者信息

Michel O, Brusis T, Loennecken I, Matthias R

机构信息

Klinik und Poliklinik für HNO-Krankheiten, Universität zu Köln.

出版信息

HNO. 1990 Feb;38(2):71-6.

PMID:2318672
Abstract

Lumbar puncture for myelography, spinal anaesthesia and aspiration of cerebrospinal fluid is a very common procedure. Although it has been known for a long time that hearing impairment may be a late complication, only a few case reports have been published, and not all have included audiograms. We present nine cases of hearing loss following myelography, lumbar puncture and spinal anaesthesia. It appears likely that this rare complication arises only in subjects with a wholly or partially patent cochlear aqueduct, allowing loss of perilymphatic fluid into the cerebrospinal space. Hearing loss was seen in eight of nine patients in the lower frequencies and in six of nine patients on both sides. Hearing recovered in six of nine patients. Transient hearing loss may occur more often than is generally assumed, and the symptom can remain unnoticed. Since not all of these hearing losses proved to be fully reversible, we suggest to inform patients about this complication for medico-legal reasons.

摘要

用于脊髓造影、脊髓麻醉和脑脊液抽吸的腰椎穿刺是一种非常常见的操作。尽管长期以来人们都知道听力障碍可能是一种晚期并发症,但仅有少数病例报告发表,且并非所有报告都包含听力图。我们呈现了9例脊髓造影、腰椎穿刺和脊髓麻醉后听力损失的病例。这种罕见的并发症似乎仅发生在耳蜗导水管完全或部分通畅的患者中,使得外淋巴液漏入脑脊液间隙。9例患者中有8例出现低频听力损失,9例患者中有6例双侧听力损失。9例患者中有6例听力恢复。短暂性听力损失的发生可能比一般认为的更为频繁,且该症状可能未被注意到。由于并非所有这些听力损失都被证明是完全可逆的,出于医疗法律原因,我们建议告知患者这一并发症。

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