Gentamicin之耳毒性－病例報告

Ototoxicity by Gentamicin - Case Report

王枝文(Jy-Wen Wang) ； 彭森源(Sen-Yuan Perng) ； 洪清潭(Ching-Tarn Horng)

《中華民國耳鼻喉科醫學會雜誌》 32卷2期 (1997/04) Pp. 216-221

https://doi.org/10.6286/1997.32.2.216

摘要

自從1963年gentamicin問世之後，因為其抗菌範圍廣泛，價格低廉，遂成為最常使用的抗生素之一；但其副作用中對重要臟器之毒性，包括內耳、腎臟，卻也限制了其發展潛力。耳毒性之臨床症狀有突然聽力減退、耳鳴、頭暈、失衡感、步態不穩、噁心及嘔吐。本文特提出因醫師對gentamicin的副作用之警覺性不夠高，而造成使用不當，所產生耳毒性之病例，並利用有限之耳神經學檢查儀器，包括常規聽力檢查、聽性腦幹反應檢查及電腦輔助之溫差測試，追蹤此例6個月，就其結果似乎顯示出使用gentamicin所引起之耳毒性中耳蝸較易再生、易殘存有較高頻率之聽力損傷和較不易恢復之前庭功能。

關鍵字

耳毒性 ； 超高頻率聽力檢查 ； 短潛時前庭激發反應

並列摘要

Since gentamicin was discovered in 1963, it has become one of the most popu-lar antibiotics because of being bacterici-dal and cheap. But the main limits to the prescription of gentamicin is its remark-able nephrotoxicity and ototxicity, both on the cochlea and the vestibule. Ototoxicity affects the hearing at the high frequencies first, and then the low frequencies. It also concerns a predominantly irreversible dete-rioration of vestibular function. In this reported case, ototoxicity happened because the physician lost of warning away from adverse reaction of gentamicin. Moni-torings of cochlear and vestibular functions including pure tone audiometry, auditory brainstem response and computer assisted caloric test were regularly recorded for six months in our study. The results reveal that the cochlear function recovered easirer than the vestibular function in this particular case. Gentamicin could result in persistent hearing loss at high frequencies and an irreversible deterioration of the vestibular function.

並列關鍵字

ototoxicity ； ultra-high frequency audiometry ； short latency vestibular evoked response