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; 张竹花; 连伟

doi:10.24920/003856

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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

中国医学科学杂志（英文版） 2021年36卷第2期页码：120-126

Original Article | Updated：2024-04-10

- 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
- Affiliations：
  
  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
- Author bio：
  
  *Zhuhua Zhang, Tel: 86-15010147685, E-mail: 15010147685@163.com,
  *Wei Lian, Tel: 86-13501262728, E-mail: UP20000@sohu.com
- Funds：
- DOI：10.24920/003856
  中图分类号：
- 收稿日期：2020-11-23，
  
  网络出版日期：2021-04-09，
  
  纸质出版日期：2021-06-30
- Accepted：
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王轶, 张竹花, 连伟. 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[J]. 中国医学科学杂志（英文版）, 2021,36(2):120-126.

Wang Yi, Zhang Zhuhua, Lian Wei. Sudden Sensorineural Hearing Loss after Pituitary Adenoma Resection—A Case Series with Literature Review[J]. Chinese medical sciences journal, 2021, 36(2): 120-126.
王轶, 张竹花, 连伟. 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[J]. 中国医学科学杂志（英文版）, 2021,36(2):120-126. DOI： 10.24920/003856.

Wang Yi, Zhang Zhuhua, Lian Wei. Sudden Sensorineural Hearing Loss after Pituitary Adenoma Resection—A Case Series with Literature Review[J]. Chinese medical sciences journal, 2021, 36(2): 120-126. DOI： 10.24920/003856.

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。

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.

关键词

Keywords

references

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