Chinese Medical Sciences Journal ›› 2021, Vol. 36 ›› Issue (2): 120-126.doi: 10.24920/003856

• 论著 • 上一篇    下一篇

垂体瘤切除术后突发感音神经性聋—病例系列报告及文献复习

王轶1,张竹花2,*(),连伟3,*()   

  1. 1中国医学科学院 北京协和医学院 北京协和医院耳鼻喉科 北京 100730
    2中国医学科学院 北京协和医学院 北京协和医院放射科 北京 100730
    3中国医学科学院 北京协和医学院 北京协和医院神经外科 北京 100730
  • 收稿日期:2020-11-23 出版日期:2021-06-30 发布日期:2021-07-07
  • 通讯作者: 张竹花,连伟 E-mail:15010147685@163.com;UP20000@sohu.com

Sudden Sensorineural Hearing Loss after Pituitary Adenoma Resection—A Case Series with Literature Review

Yi Wang1,Zhuhua Zhang2,*(),Wei Lian3,*()   

  1. 1Department of Otolaryngology,Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
    2Department of Clinical Radiology,Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
    3Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
  • Received:2020-11-23 Published:2021-06-30 Online:2021-07-07
  • Contact: Zhuhua Zhang,Wei Lian E-mail:15010147685@163.com;UP20000@sohu.com

摘要:

目的 经蝶垂体瘤术后术后患者较少出现延迟的突发性感音神经性聋。本研究报告了3例垂体瘤患者,术后无脑脊液漏或脑膜炎,但是在术后3至7日发生突发性感音神经性聋,并讨论了可能的致聋原因。
方法 对3例经蝶垂体瘤术后延迟出现突发性感音神经性聋病例,报告其病史、突发性聋的发生时间、伴随症状如头痛、耳鸣、眩晕、耳闷等,以及术后MRI表现、治疗、听力恢复等情况。
结果 术后3至7日突发极重度感音神经性聋的3例患者,听力下降前全都伴发头痛、耳鸣、眩晕。1例有间断反复发作的眩晕、耳闷、波动性听力下降,持续至术后1个月。2例有动脉硬化、冠心病史或脑梗史。3例患者中2例术后第1天MRI显示梗阻性脑积水。在口服泼尼松、鼓室注射低塞米松、服用神经营养药物和扩血管药物3至8个月之后,3例患者听力均有部分恢复。术后梗阻性脑积水和内听动脉缺血可能造成术后耳聋。
结论 经蝶垂体瘤术后梗阻性脑积水和迷路动脉缺血可能引起延迟出现的突发性感音神经性聋。

关键词: 经蝶垂体瘤切除术, 阻塞性脑积水, 内听动脉缺血, 突发性感音神经性聋, 耳鸣

Abstract:

Objective Complications after transsphenoidal surgery for pituitary adenoma have been well documented in the literatures, but the occurrence of delayed sudden sensorineural hearing loss (SNHL) after pituitary adenoma resection is extremely rare. In this study three cases who developed sudden SNHL 3 to 7 days after pituitary adenoma surgery without experiencing cerebrospinal fluid leak or meningitis were presented, and the possible causes of SNHL were discussed.
Methods Three cases with sudden hearing loss after transsphenoidal surgery for pituitary adenoma were reviewed. The past medical history, onset of sudden hearing loss, accompanying symptoms such as headache, tinnitus, dizziness and aural fullness, and the post-operative MRI images, therapy, and hearing results were reported.
Results Three cases developed profound sudden SNHL on the 3rd to 7th post-operative day, all accompanied by prior headache, tinnitus and dizziness. One patient developed episodic vertigo, ear fullness accompanying with fluctuating hearing loss in the first post-operative month. Two patients had past medical history of arteriosclerosis and coronary heart disease or cerebral infarction. Two of three demonstrated obstructive hydrocephalus on MRI on the first post-operative day. Under treatment with prednisone orally, dexamethasone intratympanic injection, neurotrophic and vasodilatation drugs for 3 to 8 months, hearing of all three improved partially. Obstructive hydrocephalus and ischemia might be responsible for the hearing loss.
Conclusion Post-operative obstructive hydrocephalus and ischemia of labyrinthine arteries might lead to the delayed SNHL after transsphenoidal surgery for pituitary adenoma.

Key words: transsphenoidal surgery for pituitary adenoma, obstructive hydrocephalus, ischemia of internal auditory arteries, sudden sensorineural hearing loss, tinnitus

Copyright © 2018 Chinese Academy of Medical Sciences. All right reserved.
 
www.cmsj.cams.cn
京公安备110402430088 京ICP备06002729号-1  Powered by Magtech.

Supervised by National Health & Family Plan Commission of PRC

9 Dongdan Santiao, Dongcheng district, Beijing, 100730 China

Tel: 86-10-65105897  Fax:86-10-65133074 

E-mail: cmsj@cams.cn  www.cmsj.cams.cn

Copyright © 2018 Chinese Academy of Medical Sciences

All right reserved.

京公安备110402430088  京ICP备06002729号-1