Harris J P, Low N C, House W F
Am J Otol. 1985 Sep;6(5):371-7.
Acoustic tumor surgery provided an ideal model in which to study possible contralateral hearing loss following a destructive surgical procedure on the inner ear. Follow-up audiometric studies were performed on patients with unilateral acoustic tumors who had undergone resection of their tumors. Patients who had obvious causes for contralateral hearing loss, such as chronic otitis media, unrelated otologic surgery, and noise-induced hearing loss, were excluded from this patient population. A total of 380 patients had available pre- and postoperative audiograms. A mean air-conduction threshold (500, 1000, 2000 Hz) of greater than or equal to 20 dB was considered a significant hearing loss. After adjusting these losses for presbycusis, 1.3% of these patients still had a significant contralateral hearing loss. We discuss the possible causes for the development of contralateral hearing loss and examine the possibility that, following surgical manipulation and injury to the inner ear, immunocompetent cells become sensitized to previously unseen inner ear antigens, setting the stage for contralateral inner ear dysfunction. The similarities of this condition to sympathetic ophthalmia are discussed.
听神经瘤手术为研究内耳破坏性手术操作后可能出现的对侧听力损失提供了一个理想模型。对接受肿瘤切除术的单侧听神经瘤患者进行了随访听力测定研究。有明显对侧听力损失原因的患者，如慢性中耳炎、无关的耳科手术和噪声性听力损失，被排除在该患者群体之外。共有380例患者有术前和术后的听力图。平均气导阈值（500、1000、2000赫兹）大于或等于20分贝被认为是显著听力损失。在对这些损失进行老年性耳聋校正后，这些患者中有1.3%仍有显著的对侧听力损失。我们讨论了对侧听力损失发生的可能原因，并探讨了在内耳手术操作和损伤后，免疫活性细胞是否会对以前未见过的内耳抗原产生致敏，从而为对侧内耳功能障碍奠定基础的可能性。还讨论了这种情况与交感性眼炎的相似之处。
