Two Cases of Sudden Sensorineural Hearing Loss After Methadone Overdose
Two Cases of Sudden Sensorineural Hearing Loss After Methadone Overdose
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DOI：
10.1345/aph.1m250
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发表时间：
2010-01-01
影响因子：
2.9
通讯作者：
Marjala, Andrew R. P.
中科院分区：
文献类型：
--
作者：
Christenson, Bret J.;Marjala, Andrew R. P.
目的：记录2例美沙酮过量后突发性感音神经性听力损失（SSHL）的表现。病例总结：我们报告2例急性，双侧美沙酮性听力损失，发生在同一天晚上在我们的急诊科。一名30岁的男性和他25岁的妻子被发现在家中摄入了未知的，但可能是大量的美沙酮后失去了反应。通过快速的内部尿液药物筛查以及通过气相色谱-质谱法的综合分析，在每位患者中排除了通常被归类为耳毒性的药物。美沙酮和四氢大麻酚（THC）是毒理学筛查中发现的唯一两名患者共有的药物。这名男子的治疗过程很长，包括在重症监护室呆了几天。该妇女完全康复，并在入院一天内出院。两名患者的听力损失在24小时内完全恢复。讨论：几种药物通常与耳毒性有关，包括非甾体抗炎药、抗生素、袢利尿剂和化疗药物。虽然罕见，但药物引起的SSHL已被记录在案，特别是在海洛因注射后静脉注射药物滥用者中。到目前为止，只有一篇已发表的病例报告记录了美沙酮引起的药物性SSHL。结论：我们认为美沙酮可能是这两例患者SSHL的原因，因为它和四氢大麻酚是毒理学筛查中唯一常见的药物，最近的病例报告涉及美沙酮引起的SSHL，并且因为患者听力的突然发作和恢复与摄入时间一致。纳兰霍概率量表评分显示，每个患者的不良反应是可能的。
OBJECTIVE: To document the presentation of 2 cases of sudden sensorineural hearing loss (SSHL) following methadone overdose.CASE SUMMARY: We report 2 cases of acute, bilateral methadone-induced hearing loss that took place on the sa me night in our emergency department. A 30-year-old male and his 25-year-old fife were found unresponsive in their home after ingesting an unknown, but presumably large, quantity of methadone. Drugs that are typically categorized as ototoxic were ruled out in each patient via rapid in-house urine drug screens as well with a comprehensive analysis via gas chromatography mass spectrometry. Methadone and tetrahydrocannabinol (THC) were the only drugs found in the toxicology screenings that were common to both patients. The man had a long treatment course that included several days in the intensive care unit. The woman recovered completely and was discharged within a day of admission. The hearing loss in both patients reversed completely within 24 hours.DISCUSSION: Several medications are commonly associated with ototoxicity, including nonsteroidal antiinflammatory drugs, antibiotics, loop diuretics, and chemotherapy agents. Although rare, drug-induced SSHL has been documented particularly among intravenous drug abusers after heroin injection. Until now, there has been only one published case report documenting drug-induced SSHL attributed to methadone.CONCLUSIONS: We believe methadone to be the probable cause of SSHL in both patients, because it and THC were the only common drugs found on toxicology screens, a recent case report involved methadone-induced SSHL, and because of the suddenness of the onset and recovery of the patient's hearing coinciding with the time frame of the ingestion. The Naranjo probability scale score revealed that the adverse reaction was probable for each patient.