新冠病毒感染患者的双侧突发性感觉神经性聋和内耳出血。
Bilateral Sudden Sensorineural Hearing Loss and Intralabyrinthine Hemorrhage in a Patient With COVID-19.
机构信息
Department of Otolaryngology-Head & Neck Surgery, NewYork-Presbyterian/Columbia University Irving Medical Center and Columbia University Vagelos College of Physicians and Surgeons, New York, New York.
Department of Otolaryngology-Head & Neck Surgery, NewYork-Presbyterian/Weill Cornell Medical Center, New York, New York.
出版信息
Otol Neurotol. 2021 Jan;42(1):e10-e14. doi: 10.1097/MAO.0000000000002860.
OBJECTIVE
To describe a case of bilateral sudden sensorineural hearing loss (SSNHL) and intralabyrinthine hemorrhage in a patient with COVID-19.
STUDY DESIGN
Clinical capsule report.
SETTING
Tertiary academic referral center.
PATIENT
An adult woman with bilateral SSNHL, aural fullness, and vertigo with documented SARS-CoV-2 infection (IgG serology testing).
INTERVENTIONS
High-dose oral prednisone with taper, intratympanic dexamethasone.
MAIN OUTCOME MEASURES
Audiometric testing, MRI of the internal auditory canal with and without contrast.
RESULTS
A patient presented with bilateral SSNHL, bilateral aural fullness, and vertigo. Serology testing performed several weeks after onset of symptoms was positive for IgG COVID-19 antibodies. MRI showed bilateral intralabyrinthine hemorrhage (left worse than right) and no tumor. The patient was treated with two courses of high-dose oral prednisone with taper and a left intratympanic dexamethasone injection, resulting in near-resolution of vestibular symptoms, a fluctuating sensorineural hearing loss in the right ear, and a severe to profound mixed hearing loss in the left ear.
CONCLUSIONS
COVID-19 may have otologic manifestations including sudden SSNHL, aural fullness, vertigo, and intralabyrinthine hemorrhage.
目的
描述 1 例 COVID-19 患者的双侧突发性感觉神经性听力损失（SSNHL）和内淋巴出血病例。
研究设计
临床病例报告。
设置
三级学术转诊中心。
患者
1 例双侧 SSNHL、耳闷和眩晕的成年女性，伴有已确诊的 SARS-CoV-2 感染（IgG 血清学检测）。
干预措施
大剂量口服泼尼松龙递减疗法，鼓室内地塞米松注射。
主要观察指标
听力学测试，内听道 MRI 平扫和增强扫描。
结果
1 例患者双侧 SSNHL、双侧耳闷和眩晕。症状出现数周后进行的血清学检测 IgG COVID-19 抗体阳性。MRI 显示双侧内淋巴出血（左侧比右侧严重），无肿瘤。该患者接受了两疗程大剂量口服泼尼松龙递减疗法和 1 次左侧鼓室内地塞米松注射治疗，导致前庭症状几乎完全缓解，右侧耳波动性感觉神经性听力损失，左侧耳严重至重度混合性听力损失。
结论
COVID-19 可能有耳部表现，包括突发性 SSNHL、耳闷、眩晕和内淋巴出血。
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