Pamuk Ahmet Erim, Pamuk Gözde, Bajin Münir Demir, Yildiz F Gokcem, Sennaroğlu Levent
Clinic of Otorhinolaryngology, Akyurt State Hospital, Ankara, Turkey.
Department of Otorhinolaryngology, Hacettepe University School of Medicine, Ankara, Turkey.
J Int Adv Otol. 2018 Aug;14(2):330-333. doi: 10.5152/iao.2018.4782.
We present a rare case of traumatic facial and vestibulocochlear nerve injury in the internal acoustic canal in the absence of a temporal bone fracture. A 2.5-year-old female presented with sudden-onset left-sided facial paralysis and ipsilateral total hearing loss after being hit by a falling television. High-resolution computed tomography revealed an occipital fracture line that spared the temporal bone and otic capsule. Diagnostic auditory brainstem response testing showed that wave V at 90-db normal hearing level was absent in the left ear. Needle electromyography revealed severe axonal injury. Facial paralysis regressed to House-Brackmann grade IV 9 months after the trauma, and no surgical intervention was scheduled. Traumatic facial and vestibulocochlear nerve injury can occur in the absence of a temporal bone fracture. Thus, careful evaluation of the internal acoustic canal is mandatory if concurrent 7th and 8th cranial nerve paralyses exist with no visible fracture line.
我们报告一例罕见的创伤性面神经和前庭蜗神经在内耳道损伤，而颞骨无骨折。一名2.5岁女性在被倒下的电视机击中后，突然出现左侧面瘫和同侧全聋。高分辨率计算机断层扫描显示枕骨骨折线，未累及颞骨和听囊。诊断性听觉脑干反应测试显示左耳在90分贝正常听力水平时V波消失。针极肌电图显示严重轴索损伤。创伤9个月后面瘫恢复至House-Brackmann Ⅳ级，未安排手术干预。即使颞骨无骨折，创伤性面神经和前庭蜗神经损伤也可能发生。因此，如果同时存在第Ⅶ和第Ⅷ颅神经麻痹且无可见骨折线，对内耳道进行仔细评估是必要的。
