Li Bang-Liang, Xu Jia-Yuan, Lin Sen
Department of Ear, Nose, and Throat, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China.
World J Clin Cases. 2022 May 26;10(15):4895-4903. doi: 10.12998/wjcc.v10.i15.4895.
To summarize the clinical characteristics of acute cerebral infarction (ACI) in patients with sudden deafness (SD) as the first symptom, improve the awareness of the disease, and help diagnosis and treatment.
From 2019 to 2020, three patients with ACI with SD as the first symptom were admitted to our hospital. Pure tone audiometry, head magnetic resonance imaging (MRI), vertebral artery and carotid artery B-ultrasound, head and neck computed tomography angiography, and other examinations were performed. Following the treatment of SD, hearing and dizziness were not significantly improved. Then, the patients developed symptoms of related cranial nerve injury, and brain MRI showed cerebral infarction in the cerebellopontine angle area. All three cases were transferred to the neurology department for relevant conservative treatment.
Patients with ACI with SD as the first symptom usually attend the otolaryngology clinic. Here a diagnosis of SD, which is based on an audiological examination, is made and the corresponding treatment is administered. To reduce the misdiagnosis of this disease, close attention should be paid to the changes in the patient's clinical symptoms and related auxiliary examinations should be performed, such as brain MRI and cerebrovascular imaging. Otolaryngologists should pay attention to the type and severity of hearing loss, the accompanying symptoms, age, high-risk factors for cerebral infarction, and related cranial nerve symptoms in patients with SD. If the patient's early brain MRI does not show abnormalities, monitoring remains essential. The head MRI should be analyzed quickly based on the changes in the symptoms of the patient, to make an accurate diagnosis and provide the timely and correct treatment for the patients.
总结以突发性聋(SD)为首发症状的急性脑梗死(ACI)患者的临床特征,提高对该疾病的认识,以助于诊断和治疗。
2019年至2020年,我院收治了3例以SD为首发症状的ACI患者。进行了纯音听力测定、头部磁共振成像(MRI)、椎动脉及颈动脉超声、头颈部计算机断层血管造影等检查。在对SD进行治疗后,听力和头晕症状未明显改善。随后,患者出现相关脑神经损伤症状,脑部MRI显示桥小脑角区脑梗死。3例患者均转入神经内科进行相关保守治疗。
以SD为首发症状的ACI患者通常首诊于耳鼻喉科门诊。在此根据听力学检查做出SD诊断并给予相应治疗。为减少该疾病的误诊,应密切关注患者临床症状变化并进行相关辅助检查,如脑部MRI和脑血管成像。耳鼻喉科医生应关注SD患者的听力损失类型和严重程度、伴随症状、年龄、脑梗死高危因素及相关脑神经症状。如果患者早期脑部MRI未显示异常,监测仍至关重要。应根据患者症状变化快速分析头部MRI,以做出准确诊断并为患者提供及时、正确的治疗。