Treviño González José Luis, Soto-Galindo German A, Moreno Sales Rafael, Morales Del Ángel Josefina A
Department of Otolaryngology-Head and Neck Surgery, University of Nuevo Leon, Medicine School and University Hospital, Mexico.
Ann Med Surg (Lond). 2018 Apr 30;30:50-53. doi: 10.1016/j.amsu.2018.04.030. eCollection 2018 Jun.
The Cogan's syndrome (CS) is a very uncommon inflammatory condition that appears in young adults without a gender predisposition. It can be presented as typical, with interstitial non-syphilitic keratitis and Ménière-like audiovestibular manifestations. An atypical form of CS involves uveitis, scleritis, episcleritis, and systemic vascuitis symptoms. This is a case of a 41-year old male who reported eye redness, photophobia, and gait instability. His condition progressed to a sudden sensorineural hearing loss, tinnitus, and constant vertigo accompanied by cephalea. He was evaluated by the Otolaryngology, Ophthalmology, and Neurology departments giving rise to CS, Ménière's syndrome, acoustic neuroma, glaucoma, multiple sclerosis, and meningioma as differential diagnoses. The patient was prescribed with oral and intravenous steroids, ophthalmic antibiotics and steroids, as well as oral omeprazole. The patient was discharged, without his eye manifestations, and for his clinical progress and underwent conventional and speech audiometry, otoacoustic emissions, nystagmography, tympanometry, and auditory steady-state response, that showed a vestibular disfunction and a severe sensorineural hearing loss. His follow-up, six months later resulted with a normal vestibular function and an improvement from severe to mild sensorineural hearing loss. The Cogan's syndrome is a rare condition which can leave the patient with permanent incapacitating secuelae including profound hearing loss. Effective treatment is necessary to avoid complications and improve the patient's condition and life quality.
科根综合征（CS）是一种非常罕见的炎症性疾病，多见于年轻成年人，无性别倾向。它可表现为典型症状，即间质性非梅毒性角膜炎和梅尼埃样听觉前庭表现。CS的非典型形式包括葡萄膜炎、巩膜炎、表层巩膜炎和系统性血管炎症状。这是一例41岁男性患者，报告有眼红、畏光和步态不稳症状。其病情进展为突发感音神经性听力损失、耳鸣和持续性眩晕，并伴有头痛。耳鼻喉科、眼科和神经科对其进行了评估，鉴别诊断包括科根综合征、梅尼埃综合征、听神经瘤、青光眼、多发性硬化症和脑膜瘤。该患者接受了口服和静脉注射类固醇、眼科抗生素和类固醇以及口服奥美拉唑治疗。患者出院时眼部症状消失，针对其临床进展进行了传统听力测试和言语听力测试、耳声发射测试、眼震电图测试、鼓室图测试以及听觉稳态反应测试，结果显示存在前庭功能障碍和严重的感音神经性听力损失。六个月后的随访结果显示其前庭功能正常，感音神经性听力损失从重度改善为轻度。科根综合征是一种罕见疾病，可使患者遗留永久性致残后遗症，包括严重听力损失。需要进行有效治疗以避免并发症并改善患者病情和生活质量。
