Kim Chang-Hee, Shin Jung Eun, Park Hong Ju, Koo Ja-Won, Lee Jun Ho
Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Republic of Korea.
Asan Medical Center, Ulsan University College of Medicine, Republic of Korea.
Med Hypotheses. 2014 Apr;82(4):424-7. doi: 10.1016/j.mehy.2014.01.015. Epub 2014 Jan 20.
The etiology of benign paroxysmal positional vertigo (BPPV) is still elusive even though detached otolith particles from the utricular macula are generally thought to be responsible for the pathogenesis of BPPV. Sudden sensorineural hearing loss (SSNHL), of which the etiology is also idiopathic in most cases, may accompany concurrent BPPV. This uncommon condition of concurrent BPPV with SSNHL has been assumptively explained as selective damage of the cochlea and the utricle due to viral neurolabyrinthitis. Recently, radiological evidences that inner ear hemorrhage is observed in patients with SSNHL accompanied by severe vertigo have been reported. The basic hypothesis for this study is that blood debris in the endolymphatic fluid due to inner ear hemorrhage is one of the causes of concurrent posterior semicircular canal (PSCC) BPPV in patient with ipsilateral SSNHL. In this report, we will outline the clinical findings of 4 patients with PSCC BPPV with SSNHL, and present an experimental results using whole blood in artificial endolymph to evaluate the hypothesis.
尽管一般认为来自椭圆囊斑的耳石颗粒脱落是良性阵发性位置性眩晕（BPPV）发病机制的原因，但BPPV的病因仍然难以捉摸。突发性感音神经性听力损失（SSNHL）在大多数情况下病因也为特发性，可能与BPPV同时出现。这种BPPV与SSNHL同时出现的罕见情况被推测为是由于病毒性神经迷路炎导致耳蜗和椭圆囊的选择性损伤。最近，有报道称在伴有严重眩晕的SSNHL患者中观察到内耳出血的影像学证据。本研究的基本假设是，内耳出血导致内淋巴液中的血液残渣是同侧SSNHL患者并发后半规管（PSCC）BPPV的原因之一。在本报告中，我们将概述4例PSCC BPPV合并SSNHL患者的临床发现，并展示使用全血在人工内淋巴中进行实验的结果以评估该假设。
