硬腦膜下血腫併發突發性耳聾

Subdural Hematoma Complicated with Sudden Deafness

余昊璋(Hao-Chang Yu) ； 王弘毅(Hung-I Wang) ； 劉博仁(Po-Jen Liu) ； 陳勝庸(Sheng-Yung Chen)

《台灣耳鼻喉頭頸外科雜誌》 44卷2期 (2009/04) Pp. 64-68

https://doi.org/10.6286/2009.44.2.64

摘要

突發性耳聾其原因大多不明，目前以病毒感染、血管病變、耳內膜破裂爲最有可能的原因，搜尋所有英文文獻，由硬腦膜下血腫併發突發性耳聾則未曾有報告。本科於2007年3月經歷1名38歲男性，主訴右側聽力喪失近1個月，純音聽力檢查顯示右耳低頻感音性聽障，診斷爲突發性耳聾，治療1個月後，聽力並無改善，且病患出現嚴重的頭痛與嘔吐，經腦部核磁共振檢查顯示右側大腦額－顳－枕葉有大範圍的硬腦膜下血腫，經神經外科以開顱術引流積血，右耳平均聽力閾值於術後完全恢復。1個多月後，病患再一次遭遇復發性硬腦膜下血腫併發突發性耳聾，經治療後，聽力喪失卻未能改善。本文除報告病例外，並對硬膜下血腫併發突發性耳聾之機轉加以探討。

關鍵字

突發性耳聾 ； 硬腦膜下血腫

並列摘要

The potential causes and pathogenesis of idiopathic sudden deafness remain unknown. Proposed theories include viral infection, vascular compromise, and intracochlear membrane rupture. We report a case of subdural hematoma complicated with sudden deafness. A 38-year-old male patient presented with right side sudden deafness for 1 month. Pure tone audiogram (PTA) showed low tone sensorineural hearing loss on the right side. One month after medication treatment, the symptom of hearing loss was persisted and severe headache, vomiting were noted at the time. A brain MRI was performed and demonstrated one large subdural hematoma over the right Fronto-temporo-parietal area with marked mass effect. The patient was referred to a neurosurgeon and underwent a craniectomy with burr hole. After operation, the symptom of hearing loss was improved completely. However, similar episode with right sudden deafness due to recurrent subdural hematoma occurred again, and it got no hearing improvement despite aggressive surgical treatment.

並列關鍵字

sudden deafness ； subdural hematoma