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无面神经麻痹病史的特发性眼镫骨联动

Idiopathic oculostapedial synkinesis without history of facial nerve palsy.

作者信息

Fujiwara Keishi, Furuta Yasushi, Fukuda Satoshi

机构信息

*Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Hokkaido University; and †Department of Otolaryngology, Head and Neck Surgery, Teine-Keijinkai Hospital, Sapporo, Hokkaido, Japan.

出版信息

Otol Neurotol. 2015 Mar;36(3):510-2. doi: 10.1097/MAO.0000000000000460.

Abstract

OBJECTIVE

To report a case of idiopathic oculostapedial synkinesis without facial nerve disorder.

PATIENT

A 30-year-old woman with tinnitus synchronous with eye closure is presented. The patient had no history of facial nerve disorder.

RESULT

An impedance audiometer, in the absence of an auditory stimulus, was used to record tympanic membrane compliance without sound stimulation, revealing decreased compliance in the concomitant with eye blinking. Her symptoms disappeared spontaneously, so no intervention was undertaken.

CONCLUSION

Although oculostapedial synkinesis is often observed as one of the sequelae of facial nerve palsy, idiopathic oculostapedial synkinesis is very rare. The use of an impedance audiometer in the absence of an auditory stimulus is very useful for demonstrating objective changes in the compliance of the tympanic membrane. It is assumed that the cause of the synkinesis in our case was abnormal transmission of signals for orbicularis oculi muscle to the stapedial and orbicularis oris muscles rather than misdirected regenerating fibers. Resection of the stapedial muscle tendon should be considered if her symptoms recur.

摘要

目的

报告一例无面神经病变的特发性眼镫骨联动病例。

患者

一名30岁女性,出现与闭眼同步的耳鸣。该患者无面神经病变病史。

结果

在无听觉刺激的情况下,使用阻抗听力计记录无声刺激时的鼓膜顺应性,结果显示在眨眼时顺应性降低。她的症状自行消失,因此未采取干预措施。

结论

尽管眼镫骨联动常被视为面神经麻痹的后遗症之一,但特发性眼镫骨联动非常罕见。在无听觉刺激的情况下使用阻抗听力计对于显示鼓膜顺应性的客观变化非常有用。推测本例联动的原因是眼轮匝肌信号异常传递至镫骨肌和口轮匝肌,而非再生纤维错向生长。如果她的症状复发,应考虑切除镫骨肌腱。

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