Vos F I, Merkus P, van Nieuwkerk E B J, Hensen E F
Department of Otolaryngology-Head and Neck Surgery, Section Ear & Hearing, VU University Medical Center, Amsterdam, The Netherlands.
EMGO Institute for Health and Care Research, Amsterdam, The Netherlands.
BMJ Case Rep. 2016 Oct 8;2016:bcr2016216004. doi: 10.1136/bcr-2016-216004.
In this paper, we describe the case of a 62-year-old female with recurring episodes of sudden deafness with vertigo and facial paresis. Within a month's time, this resulted in bilateral deafness and vestibular areflexia. Erroneously, the patient was diagnosed with sudden deafness of unknown origin and subsequently with neuroborreliosis (Lyme disease). The true diagnosis of relapsing polychondritis (RP) was revealed 9 months after initial presentation. The diagnostic delay is in part explained by the fact that, by definition, the disease has to relapse before the diagnosis can be made, but also by its pluriform clinical presentation. Timely identification of RP as the cause of this profound sensorineural hearing loss proved to be important. It was key in instigating adequate follow-up, and allowed for cochlear implantation before total cochlear obliteration, which might have hampered optimal hearing rehabilitation.
在本文中,我们描述了一名62岁女性的病例,她反复出现突发性耳聋并伴有眩晕和面瘫。在一个月的时间内,这导致了双侧耳聋和前庭反射消失。该患者被错误地诊断为不明原因的突发性耳聋,随后又被诊断为神经莱姆病。在初次就诊9个月后,才确诊为复发性多软骨炎(RP)。诊断延迟部分是因为根据定义,该疾病必须复发才能做出诊断,还因为其临床表现多样。及时识别RP是导致这种严重感音神经性听力损失的原因被证明很重要。这是启动充分随访的关键,并允许在耳蜗完全闭塞之前进行人工耳蜗植入,否则可能会妨碍最佳的听力康复。