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自由潛水造成的外淋巴瘻管-病例報告

Perilymphatic Fistula Developed Following Free Diving-Case Report

摘要


耳內圓窗及卵圓窗可能因氣壓劇烈變化而破裂,產生外淋巴瘻管而引起外淋巴液滲出,導致聽力障礙與不平衡感。因自由潛水所造成的外淋巴瘻管,為臨床上少見之病例,由於症狀不具專一性,因此難以在治療前得到明確的診斷。往往需要相關潛水病史、病患出現波動型感音神經性聽力喪失,甚至經由鼓室探查手術才能診斷出來。本文報告1例31歲男性因深度自由潛水引發單側聽力障礙及不平衡感,疑似外淋巴瘻管,經鼓室探查手術並利用耳垂軟組織填塞圓窗及卵圓窗後,病患聽力恢復正常且頭暈改善。本文分享此案例並討論自由潛水造成的外淋巴瘻管。

並列摘要


A drastic change in pressure may rupture the oval window and round window membrane of the ear, causing the leakage of perilymph into the middle-ear cavity. This can lead to hearing impairment and dizziness among patients. Perilymphatic fistula (PLF) developed following free diving is a rare clinical condition and is difficult to diagnose before treatment due to its nonspecific symptoms. Diagnosis often requires confirmation of a history of diving, examination of fluctuating sensorineural hearing loss, and even exploratory tympanotomy. We present the case of a 31-year-old man who developed unilateral hearing impairment, unsteadiness anddizziness after deep free diving. On the basis of the symptoms, PLF was suspected. After exploratory tympanotomyand repair of the rupture of the round window and oval window membrane by using soft tissue from the earlobe, the patient's hearing returned to normal, and his dizziness also improved. This article discusses this case and provides insights into PLF.

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