人工耳蝸植入於語後失聰合併對側小腦橋腦角腦膜瘤之成人患者

Cochlear Implantation in a Postlingually Deaf Adult with Contralateral Cerebellopontine Angle Meningioma

李忠耕(Chung-Keng Lee) ； 陳金城(Jin-Cherng Jin) ； 何旭爵(Hsu-Chueh Ho)

《台灣耳鼻喉頭頸外科雜誌》 44卷2期 (2009/04) Pp. 59-63

https://doi.org/10.6286/2009.44.2.59

摘要

雙側重度或極重度感音神經性聽損之成人，於配戴助聽器治療後，仍無法有效改善聽力，並且語言認知能力低於40%至50%，這類患者可選擇人工耳蝸植入手術來改善聽力。本病例爲一名36歲男性，主訴在19歲時因頭部外傷而導致右側聽損，之後在30歲時，又發生漸進性左側聽損，於是病患開始配戴助聽器約4年，但聽力越來越差，由於雙側聽損，遂求診於本院耳鼻喉科，聽力檢查顯示爲雙側極重度感音神經性聽損，因此建議病患接受人工耳蝸植入手術，遂安排顳骨斷層掃描及頭部磁振造影檢查，於頭部磁振造影中發現一腫瘤位於左側小腦橋腦角(cerebellopontineangle tumor)並侵犯到內耳道，因此病患於本院神經外科接受腫瘤切除手術，病理組織報告顯示此腫瘤爲腦膜瘤。在腫瘤切除手術前曾安排右耳之鼓岬電刺激試驗(promontory test)，結果顯示病患之右側中樞聽覺神經路徑仍有功能。腫瘤切除術後8個月，病患接受右側人工耳蝸植入手術，術後於門診追蹤時安排聽力檢查，發現右耳聽力有明顯進步。

關鍵字

人工耳蝸 ； 語後失聰 ； 小腦橋腦角腦膜瘤

並列摘要

The adults with bilateral severe-to-profound hearing loss and minimal benefit from hearing aids are candidates for cochlear implantation, if their sentence recognition scores are below 40-50% in the best aided condition. This case is a 36-year-old male patient who had right hearing impairment since the age of 19, following a head injury. He suffered from progressive left hearing impairment since the age of 30 and used to wear hearing aid about 4 years. Limited benefit from hearing aid was noted. Due to bilateral hearing impairment, he came to our hospital and pure tone audiometry showed bilateral profound sensorineural hearing loss. Thus cochlear implantation was suggested. Temporal bone CT and brain MRI were arranged for pre-operation evaluation. Brain MRI showed a tumor over left cerebellopontine angle with invasion of left inner auditory canal. Then the patient received operation in our neurosurgical department. The report of pathology showed meningioma. Eight months after neurosurgical operation, he received cochlear implantation of right ear. At follow-up, audiometry showed obvious improvement of right hearing.

並列關鍵字

cochlear implantation ； postlingually deaf ； cerebellopontine angle meningioma