Transcanal endoscopic ear surgery for perilymphatic fistula after electric acoustic stimulation
Transcanal endoscopic ear surgery for perilymphatic fistula after electric acoustic stimulation
复制标题
经耳道内窥镜耳部手术治疗电声刺激后外淋巴瘘
DOI：
10.1016/j.anl.2017.10.004
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发表时间：
2018
影响因子：
1.7
通讯作者：
Nishizaki K
中科院分区：
文献类型：
--
作者：
Omichi R;Kariya S;Maeda Y;Nishizaki K
经导管内窥镜耳科手术(TES)将成为一种非常有用的治疗选择。外淋巴瘘(PLF)是指由于外淋巴瘘从椭圆形窗和/或圆形窗渗漏而引起的突发性感音神经性聋和/或眩晕。我们报告了一例电声刺激(EAS)后PLF的病例，这是一种人工耳蜗术，经TES成功治疗。患者男，38岁，因眩晕和听力损失(HL)到本院就诊。他的眩晕是由瓦尔萨尔瓦动作引起的。八个月前，他因先天性感觉神经性HL接受了右耳的EAS手术。虽然他在EAS后保持了听力水平，但这次他的纯音测听图显示他的右耳在低频下听力下降。诊断为右侧PLF。在确定口服强的松龙治疗无效后，行PLF修补术，用T型三通修补卵圆形窗和圆窗。手术后，他的眩晕没有复发。据我们所知，这是第一例在没有显微镜的情况下用TES进行PLF修复手术的报道。TES的中耳广域视野对于预防植入人工耳蜗术后PLF患者的电极损伤非常有用。
Transcanal endoscopic ear surgery (TEES) will become a very useful therapeutic option. A perilymphatic fistula (PLF) is defined as sudden sensorineural hearing loss and/or vertigo caused by leakage of the perilymph through a fistula from the oval window and/or round window. We report a case of PLF after electric acoustic stimulation (EAS), a kind of cochlear implant, successfully treated by TEES. A 38-year-old man presented to our hospital with vertigo and hearing loss (HL). His vertigo was induced by Valsalva maneuvers. Eight months ago, he underwent EAS for his right ear for congenital sensorineural HL. Although he maintained his hearing level after EAS, his pure tone audiogram this time showed deterioration of hearing at low frequencies in his right ear. A diagnosis of right PLF was made. After confirming the non-effectiveness of oral prednisolone treatment, PLF repair surgery to patch the oval and round windows by TEES was performed. His vertigo did not recur after the surgery. To the best of our knowledge, this is the first report of PLF repair surgery by TEES without a microscope. The wide-field view of the middle ear by TEES was useful to prevent electrode damage in a PLF patient with a cochlear implant.