Goodale Adam D, Golub Justin S, Cornelius Rebecca S, Samy Ravi N
Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati Medical Center, Cincinnati, OH 45267, USA.
Department of Otolaryngology-Head and Neck Surgery, Columbia University Irving Medical Center, New York, NY, USA.
World J Otorhinolaryngol Head Neck Surg. 2016 Dec 1;2(3):181-184. doi: 10.1016/j.wjorl.2016.10.001. eCollection 2016 Sep.
We present a case of a patient with progressive unilateral sensorineural hearing loss and tinnitus with internal auditory canal enhancement on magnetic resonance imaging (MRI) secondary to isolated cochlear neuritis from varicella reactivation. MRI following antiviral treatment showed resolution of enhancement. Varicella reactivation is commonly seen in the form of Ramsay Hunt syndrome, which is known to produce abnormal MRI enhancement from facial and vestibulocochlear neuritis; however, its characteristic clinical signs aid the diagnosis. This case is unique in that the only manifestation of varicella infection was unilateral hearing loss. This case outlines the importance of maintaining a broad differential diagnosis in the evaluation of unilateral hearing loss as well as recognizing the limited specificity of MRI.
我们报告一例患者，其患有进行性单侧感音神经性听力损失和耳鸣，磁共振成像（MRI）显示内耳道强化，继发于水痘再激活引起的孤立性蜗神经炎。抗病毒治疗后的MRI显示强化消失。水痘再激活通常以拉姆齐·亨特综合征的形式出现，已知该综合征会因面神经炎和前庭蜗神经炎导致MRI异常强化；然而，其特征性临床体征有助于诊断。该病例的独特之处在于水痘感染的唯一表现是单侧听力损失。该病例概述了在评估单侧听力损失时保持广泛鉴别诊断的重要性，以及认识到MRI特异性有限的情况。
