小兒突發性耳聾

Sudden Deafness in a Child

陳建志(Jiann-Jy Chen) ； 湯耀貿(Yao-Mao Tang) ； 陳登郎(Dem-Lion Chen)

《童綜合醫學雜誌》 4卷2期 (2010/12) Pp. 89-92

https://doi.org/10.29838/TMJ.201012.0007

摘要

突發性耳聾好發於40~60歲，不足15歲者約佔所有突發性耳聾患者的5%。小兒突發性耳聾可能病因為內耳發育畸形、內耳淋巴水腫、外淋巴瘻管、腮腺炎耳聾、積液性中耳炎、偏頭痛、大前庭導水管症候群或原因不明。一10歲小女孩，在罹患病毒性腮腺炎半年後，突發左側聽力障礙及耳鳴。症狀持續了5日，自地方診所轉診至本院，囑臥床休息，並靜脈注射類固醇及血漿容積擴張劑治療。患耳250~4,000Hz處之平均聽力閾值在住院後1日時為61dBHL，住院後5日時為30dBHL，出院後2日時為15dBHL，出院後3週時為2dBHL，聽力共恢復了59dBHL。所有血液學檢查均為正常，梅毒血清測試、人類免疫缺乏病毒IgM&IgG 抗體及其他病毒IgM抗體檢查均為陰性，而複響測試、語音辨識度檢查、聽性腦幹電波反應檢查、顳骨電腦斷層及腦部磁振造影均無異常發現。經過2年的追蹤，情況依然穩定。因此，本個案之突發性耳聾目前實為原因不明，根據病史，仍有可能是腮腺炎病毒感染所致，尚需長期的追蹤，以排除內耳淋巴水腫或偏頭痛的可能。

關鍵字

突發性耳聾 ； 小兒 ； 病毒性腮腺炎耳聾 ； 內耳淋巴水腫 ； 偏頭痛

並列摘要

Sudden deafness (SD) usually affects people between 40 and 60 years old. Only 5% SD is younger than 15 years old. The possible etiologies are labyrinthine maldevelopment, endolymphatic hydrops, perilymph fistula, endolymphatic hydrops, mumps deafness, serous otitis media, migraine, large vestibular aqueduct syndrome or other unknown cause. Half year after a 10-year-old girl had suffered mumps, she presented with acute left hearing loss and tinnitus for five days. Transferred from a private clinic, she was treated with bed-rest, intravenous corticosteroids, and blood volume expander. One day after hospitalization, the average of hearing thresholds over 250~4,000Hz was 61dBHL in the affected ear; 5 days after hospitalization, 30dBHL; 2 days after being discharged, 15dBHL; and 3 weeks after being discharged, 2dBHL. Finally, her hearing was rescued 59dBHL. Blood examinations were within normal range. Rapid plasma regain of syphilis, anti-HIV (human immunodeficiency virus) IgM&IgG (EIA) and other virus IgM tests were all negative. Short increment sensitivity index, speech discrimination score, auditory brainstem response, high-resolution computed tomography of temporal bone, and magnetic resonance imaging of brain showed negative finding. In the following two years, it was uneventful. Therefore, the etiology of her SD is still unknown. According to clinical history, her SD may be attributable to mumps infection. Due to possible endolymphatic hydrops or migraine, she should be followed in the future.

並列關鍵字

sudden deafness ； pediatric ； mumps deafness ； endolymphatic hydrops ； migraine