Polyarteritis nodosa as a cause of sudden deafness. A human temporal bone study.
Polyarteritis nodosa as a cause of sudden deafness. A human temporal bone study.
复制标题
DOI：
10.1016/s0196-0709(81)80026-9
复制
发表时间：
1981-05-01
影响因子：
2.5
通讯作者：
Fisch, U
中科院分区：
文献类型：
--
作者：
Jenkins, H A;Pollak, A M;Fisch, U
本文描述了一例48岁男性结节性多动脉炎病例的颞骨病理变化，该病例在死亡前7个月出现突发性单侧耳聋和眩晕，是该疾病的早期表现之一。患者只接受了七周的强的松龙治疗，更早的时候，接受了两周的抗炎药物治疗。尸检显示供肾、睾丸和胰腺的动脉受累。双侧颞骨内可见改变，中耳黏膜增厚。内耳受累主要限于耳蜗，耳聋表现出更明显的变化。这些变化包括基底线圈钩部Corti器官的丧失，覆盖膜的缺失和血管纹的萎缩。中鼓scala因纤维化和新骨形成而消失。中耳膜水肿，螺旋神经节细胞和供应这部分耳蜗的神经纤维明显减少。其余耳蜗可见局灶性改变。前庭结构未见明显病理改变。在颞骨的硬脑膜和亚急性血管中发现小血管动脉炎。
Pathological changes in the temporal bone are described in a case of polyarteritis nodosa in a 48 year old man in whom the onset of sudden unilateral deafness and vertigo occurred seven months prior to death as one of the early manifestations of the disease. The patient had received only a seven week course of prednisolone and, earlier, a two week course of anti-inflammatory agents. Autopsy revealed involvement of the arteries supplying the kidneys, testes, and pancreas. Changes within the temporal bone were seen bilaterally and there was thickening of the mucosa of the middle ear. Inner ear involvement was mainly limited to the cochlea, the deaf ear showing more pronounced changes. These changes included loss of the organ of Corti in the hook portion of the basal coil, absence of the tectorial membrane, and atrophy of the stria vascularis. The scala tympani was obliterated by fibrosis and new bone formation. The scala media showed hydrops, and a marked decrease in the spiral ganglion cells and nerve fibers supplying this portion of the cochlea was evident. Focal changes were seen throughout the remainder of the cochlea. The vestibular structures showed no detectable pathologic changes. Small vessel arteritis was found in the dural and subacuate vessels in both temporal bones.