Covelli Edoardo, Volpini Luigi, Filippi Chiara, Tarantini Silvia, Marrone Vania, Monini Simonetta, Barbara Maurizio
Department Neuroscience Mental Health and Sensory Organs (NESMOS), Sapienza University, Rome, Italy.
J Int Adv Otol. 2017 Aug;13(2):285-288. doi: 10.5152/iao.2017.2772.
Intralabyrinthine schwannoma (ILS) is a rare benign tumor that affects the ends of cochlear and vestibular nerves. In a majority of the cases, it occurs with unilateral progressive sensorineural hearing loss. Less frequent symptoms include tinnitus, imbalance, vertigo, or fullness. The advent of magnetic resonance imaging allows early diagnosis and enables an appropriate therapeutic protocol. This report describes a case of intravestibular schwannoma, with fluctuating hearing loss and intractable vertigo, treated with intratympanic gentamicin. The patient was a 28-year-old woman with intractable vertigo and fluctuating left-side hearing loss caused by left intravestibular schwannoma. Because surgery was temporarily rejected by the patient, a single dose of intratympanic gentamicin was administered. Following this, the patient showed a significant improvement in the symptoms. However, moderate to flat sensorineural hearing loss was also observed. Intratympanic gentamicin infiltration is a valid therapeutic option for patients with ILS, affected by intractable vertigo, when the patient refuses surgery.
迷路内神经鞘瘤（ILS）是一种罕见的良性肿瘤，影响耳蜗和前庭神经的末端。在大多数情况下，它会导致单侧进行性感音神经性听力损失。较不常见的症状包括耳鸣、失衡、眩晕或耳部胀满感。磁共振成像的出现使得能够早期诊断并制定适当的治疗方案。本报告描述了一例患有波动性听力损失和顽固性眩晕的前庭内神经鞘瘤患者，采用鼓室内庆大霉素治疗。患者为一名28岁女性，因左侧前庭内神经鞘瘤导致顽固性眩晕和左侧波动性听力损失。由于患者暂时拒绝手术，给予了单剂量鼓室内庆大霉素。此后，患者症状有显著改善。然而，也观察到了中度至重度感音神经性听力损失。对于因顽固性眩晕而拒绝手术的ILS患者，鼓室内庆大霉素浸润是一种有效的治疗选择。
