Rauch Steven D
J Clin Invest. 2014 Sep;124(9):3685-7. doi: 10.1172/JCI77197. Epub 2014 Aug 18.
Clinical vignette: A 51-year-old man with right-sided sudden hearing loss presents to the otology clinic. He has a 4-year history of episodic vertigo of several hours' duration and fluctuating, progressive sensorineural hearing loss in his left ear. The vertigo attacks have not occurred for the last 18 months, and the left ear hearing is consistently poor. The patient's right ear hearing has dropped in the last 36 hours. MRI imaging of brain and temporal bone are normal. A 2-week "burst and taper" of oral prednisone is administered with no effect. Over the next 3 months, serial audiograms show rapidly progressive loss of threshold and word recognition scores on the right side. A trial of high-dose prednisone (60 mg/d for 30 days) results in full recovery of the right ear hearing and substantial improvement in the left ear. As the prednisone dose is slowly tapered over several months, the hearing drops again.
一名51岁男性因右侧突发听力损失就诊于耳科门诊。他有4年发作性眩晕病史，每次持续数小时，左耳听力呈波动性、进行性感音神经性听力损失。眩晕发作在过去18个月未再出现，左耳听力持续较差。患者右耳听力在过去36小时内下降。脑部和颞骨的MRI成像正常。给予口服泼尼松2周的“冲击和减量”治疗但无效。在接下来的3个月里，系列听力图显示右侧阈值和单词识别分数迅速进行性下降。高剂量泼尼松试验（60毫克/天，共30天）使右耳听力完全恢复，左耳也有显著改善。随着泼尼松剂量在几个月内缓慢减量，听力再次下降。
