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两次听神经瘤颅后窝手术切除后出现反复对侧听力损失:病因学意义。

Recurrent contralateral hearing loss after 2 craniotomies for vestibular schwannoma: etiologic implications.

机构信息

Division of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA.

出版信息

Otol Neurotol. 2013 Sep;34(7):1237-40. doi: 10.1097/MAO.0b013e318298dedc.

Abstract

OBJECTIVE

To describe recurrent sudden sensorineural hearing loss after contralateral vestibular schwannoma resection and re-resection.

STUDY DESIGN

Clinical capsule report.

SETTING

Tertiary academic referral hospital.

PATIENT

A patient who underwent 2 craniotomies for vestibular schwannoma.

RESULTS

In 2003, a patient experienced contralateral low-frequency sensorineural hearing loss after undergoing translabyrinthine resection of a vestibular schwannoma. This resolved after a course of oral steroids. Seven years later, in 2010, the patient developed tumor recurrence. After retrosigmoid resection, the patient experienced a similar episode of transient, contralateral, low-frequency predominant sensorineural hearing loss.

CONCLUSION

The recurrence of contralateral hearing loss after craniotomies years apart suggests that patient specific anatomic risk factors predispose an individual to hearing loss after contralateral cerebellopontine angle surgery. Patients with previous history of contralateral hearing loss should be counseled that they may be at increased risk for recurrent loss in the setting of re-resection.

摘要

目的

描述对侧前庭神经鞘瘤切除和再切除后复发性突发性感觉神经性听力损失。

研究设计

临床案例报告。

设置

三级学术转诊医院。

患者

接受过 2 次前庭神经鞘瘤开颅手术的患者。

结果

2003 年,患者行经迷路前庭神经鞘瘤切除术,术后出现对侧低频感觉神经性听力损失。经口服类固醇治疗后缓解。7 年后,即 2010 年,患者出现肿瘤复发。行乙状窦后入路切除术,术后患者出现短暂、对侧、低频为主的感觉神经性听力损失。

结论

相隔数年的颅切开术后对侧听力损失的复发表明,患者特定的解剖学危险因素使个体在桥小脑角手术后易发生听力损失。有对侧听力损失病史的患者应被告知,在再次切除的情况下,他们可能有更高的复发性听力损失风险。

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