Nomura Kazuaki, Takano Kenichi, Yamamoto Keisuke, Abe Ayumi, Takahashi Nozomi, Okuni Tsuyoshi, Himi Tetsuo
Adv Otorhinolaryngol. 2016;77:23-6. doi: 10.1159/000441866. Epub 2016 Apr 26.
Pneumolabyrinth is a rare condition with air bubbles existing in the vestibule and/or cochlea. We report a case of pneumolabyrinth without trauma that was suspected to be caused by labyrinthitis. A 65-year-old man presented with vertigo and hearing loss in the left ear after catching a cold. Computed tomography performed after there had been no improvement in the patient's symptoms showed the presence of air bubbles in the vestibule, semicircular canals and cochlea. The patient was transferred to our hospital with suspected perilymphatic fistula. Bacterial infection was suspected after the laboratory tests had indicated a severe inflammatory response, and the patient was treated with antibiotics. However, no bacteria were detected in a bacterial culture of the otorrhea. An exploratory tympanotomy was performed to improve the patient's staggering gait and to examine the middle ear, with no obvious fistula being observed. Subsequent fenestration of the round window revealed a white mass that appeared to contain bacteria which was collected from the cochlea and submitted for analysis and bacterial culture. However, no bacteria were detected and the mass contained white blood cells. We suspected pneumolabyrinth following labyrinth infection. However, the cause of air bubble formation remains unclear and needs to be validated with further research.
肺迷路是一种罕见的疾病，在前庭和/或耳蜗中存在气泡。我们报告一例无创伤性的肺迷路病例，怀疑是由迷路炎引起的。一名65岁男性在感冒后出现左耳眩晕和听力损失。在患者症状没有改善后进行的计算机断层扫描显示在前庭、半规管和耳蜗中存在气泡。该患者因疑似外淋巴瘘被转诊至我院。实验室检查显示严重炎症反应后怀疑有细菌感染，患者接受了抗生素治疗。然而，在耳漏的细菌培养中未检测到细菌。进行了探查性鼓膜切开术以改善患者的蹒跚步态并检查中耳，未观察到明显的瘘管。随后的圆窗开窗术发现了一个白色团块似乎含有从耳蜗收集的细菌，并送去进行分析和细菌培养。然而，未检测到细菌，且该团块含有白细胞。我们怀疑迷路感染后发生了肺迷路。然而，气泡形成的原因仍不清楚，需要进一步研究加以证实。
