Westerman S T, Gilbert L M, Schondel L
Hahnemann Medical College, Philadelphia, Pennsylvania, USA.
Am J Otol. 1994 May;15(3):400-3.
Children with a history of embryonic exposure to Accutane (isotretinoin) are at great risk for major physical malformations, brain malformations, and decreased intelligence. A case is presented of a 4-year 7-month-old black male with a history of embryonic exposure to Accutane who was born with embryopathy that includes bilateral major ear deformities. The child has a significant bilateral conductive hearing loss, and, in addition, a left sided sensorineural loss. Vestibular function testing revealed evidence of peripheral and central vestibular dysfunction. A course of diphenhydramine hydrochloride and Donnatal (phenobarbital, hyoscyamine sulfate, atropine sulfate, and scopolamine hydrobromide) significantly alleviated the symptoms of vestibular dysfunction. Otologic management of these children should include clinical documentation of the external deformities, evaluation of cochlear function, and early auditory habilitation. Vestibular function should also be evaluated in all children with a history of embryonic exposure to isotretinoin.
有胚胎期接触异维甲酸（阿维A）病史的儿童出现严重身体畸形、脑畸形和智力下降的风险很大。本文介绍了一名4岁7个月大的黑人男性病例，其有胚胎期接触异维甲酸的病史，出生时患有包括双侧严重耳部畸形在内的胚胎病。该儿童存在明显的双侧传导性听力损失，此外还有左侧感音神经性听力损失。前庭功能测试显示存在外周和中枢前庭功能障碍的证据。盐酸苯海拉明和唐那德（苯巴比妥、硫酸莨菪碱、硫酸阿托品和氢溴酸东莨菪碱）疗程显著缓解了前庭功能障碍的症状。对这些儿童的耳科管理应包括对外形畸形的临床记录、耳蜗功能评估以及早期听觉康复训练。对于所有有胚胎期接触异维甲酸病史的儿童，也应评估其前庭功能。
