Londero Alain, Charpentier Nicolas, Ponsot Damien, Fournier Philippe, Pezard Laurent, Noreña Arnaud J
Service ORL et CCF, Hôpital Européen G. Pompidou, Paris, France.
Faculté de médecine de Nancy, Université de Lorraine, Nancy, France.
Front Neurol. 2017 Aug 16;8:420. doi: 10.3389/fneur.2017.00420. eCollection 2017.
This study reports the case of an acoustic shock injury (ASI), which did not result in a significant hearing loss, but was followed by manifold chronic symptoms both within (tinnitus, otalgia, tingling in the ear, tension in the ear, and red tympanum) and outside the ears (blocked nose, pain in the neck/temporal region). We suggest that these symptoms may result from a loop involving injury to middle ear muscles, peripheral inflammatory processes, activation and sensitization of the trigeminal nerve, the autonomic nervous system, and central feedbacks. The pathophysiology of this ASI is reminiscent of that observed in post-traumatic trigeminal-autonomic cephalalgia. This framework opens new and promising perspectives on the understanding and medical management of ASI.
本研究报告了一例声震损伤（ASI）病例，该病例未导致明显听力损失，但随后出现了耳部内外的多种慢性症状（耳鸣、耳痛、耳部刺痛、耳部紧张感和鼓膜充血）以及耳部外的症状（鼻塞、颈部/颞部疼痛）。我们认为，这些症状可能源于一个涉及中耳肌肉损伤、外周炎症过程、三叉神经、自主神经系统激活和致敏以及中枢反馈的循环。这种声震损伤的病理生理学与创伤后三叉神经自主性头痛中观察到的相似。这一框架为声震损伤的理解和医学管理开辟了新的、有前景的视角。
