中耳胆脂瘤并发迷路瘘管和迟发性膜迷路积水1例  

A case report of middle ear cholesteatoma complicated with labyrinthine fistulaand delayed endolymphatic hydrops

作　　者：林锋 吴倩如 张毅博 戴春富 LIN Feng;WU Qianru;ZHANG Yibo;DAI Chunfu(Department of Otorhinolaryngology,Fudan University Eye and ENT Hospital,Key Laboratory of Auditory Medicine of the National Health Commission,Shanghai,200031,China)

机构地区：[1]复旦大学附属眼耳鼻喉科医院耳鼻咽喉科、国家卫生健康委员会听觉医学重点实验室,上海200031 [2]福建医科大学附属南平第一医院耳鼻咽喉科,福建南平353000

出　　处：《临床耳鼻咽喉头颈外科杂志》2023年第8期670-672,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：迟发性膜迷路积水(delayed endolymphatic hydrops,DEH)是引起眩晕一种不常见的疾病,在临床上不受重视容易误诊其他眩晕疾病。本文报道了1例容易误诊的眩晕患者。患者为中耳胆脂瘤并发迷路瘘管,然而其眩晕为发作性眩晕,不能用迷路瘘管导致迷路炎作为解释,怀疑合并有膜迷路积水可能,并经内耳MRI钆造影证实为膜迷路积水。首次报道了中耳胆脂瘤并发迷路瘘管和DEH的病例,经手术切除胆脂瘤同期行三半规管阻塞,术后随访2年内未再发作眩晕。对眩晕疾病的诊断,细致的眩晕病史询问至关重要。Delayed endolymphatic hydrops(DEH)is a rare disease that causes vertigo and is often misdiagnosed as other vertigo diseases.This article reports on a patient with vertigo who was easily misdiagnosed.The patient was a middle ear cholesteatoma complicated by labyrinthine fistula(LF);however,his vertigo was episodic vertigo,which could not be explained solely by LF causing labyrinthitis.The possibility of endolymphatic hydrops was suspected,which was confirmed by inner ear magnetic resonance gadolinium imaging.This is the first reported case of middle ear cholesteatoma complicated by LF and DEH.The patient underwent surgical resection of the cholesteatoma and three semicircular canal obstructions at the same time.During two years postoperative follow-up,the patient did not experience a recurrence of vertigo.When diagnosing vertigo diseases,a careful history of vertigo is of utmost importance.

关 键 词：迟发性膜迷路积水 迷路瘘管 中耳胆脂瘤 内耳MRI钆造影 膜迷路积水 

分 类 号：R764[医药卫生—耳鼻咽喉科]