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新冠病毒感染后与咽鼓管异常开放相关的头晕

Post-COVID-19 dizziness associated with a patulous eustachian tube.

作者信息

den Dunnen Jeroen, Bauwens Alain, Versfeld Niek J, Goderie Thadé

机构信息

Center for Infection and Molecular Medicine, Amsterdam UMC Location AMC, Amsterdam, The Netherlands.

Unité de Réhabilitation Vestibulaire, CHU UCL Namur, Yvoir, Belgium.

出版信息

BMJ Case Rep. 2025 Jun 24;18(6):e265008. doi: 10.1136/bcr-2025-265008.

Abstract

A frequently occurring symptom following COVID-19 is dizziness. Yet, the causes of post-COVID-19 dizziness are still largely unclear. This paper presents a case of a patient in his 40s who developed persistent dizziness after a SARS-CoV-2 infection. Dizziness only occurred during nasal respiration. Inspection of the tympanic membrane on respiration indicated a patulous eustachian tube (PET). Video-oculography showed a slight nystagmus during nasal respiration. Placement of a tympanostomy tube 6 months after the start of symptoms immediately resolved the dizziness, and nystagmus during nasal respiration was reduced. A few days after treatment, the patient developed ocular fatigue and pain associated with eye movement, which was diagnosed as vestibular asthenopia. These symptoms were largely resolved by subsequent treatment with vestibulo-visual rehabilitation. This case report indicates that post-COVID-19 dizziness can be associated with a PET, and in that case, it can be successfully treated by placement of a ventilation tube.

摘要

新冠病毒病(COVID-19)后经常出现的症状是头晕。然而,新冠病毒病后头晕的原因仍大多不明。本文介绍了一例40多岁的患者,其在感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)后出现持续性头晕。头晕仅在鼻腔呼吸时出现。呼吸时检查鼓膜显示咽鼓管异常开放(PET)。视频眼震图显示鼻腔呼吸时出现轻微眼球震颤。症状出现6个月后放置鼓膜造孔管立即缓解了头晕,鼻腔呼吸时的眼球震颤也减轻了。治疗几天后,患者出现与眼球运动相关的眼疲劳和疼痛,被诊断为前庭性弱视。通过后续的前庭视觉康复治疗,这些症状基本得到缓解。本病例报告表明,新冠病毒病后头晕可能与咽鼓管异常开放有关,在这种情况下,放置通气管可成功治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57ef/12198484/aa5885a2c853/bcr-18-6-g001.jpg

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