ABSTRACT
Sudden sensorineural hearing loss is a well-recognized clinical symptom in multiple sclerosis (MS). Acute inflammatory demyelination in the cochlear nerve or more central auditory tracts may cause sudden retrocochlear hearing loss. A 28-year-old male patient who was confirmed as having MS presented with suffering from dizziness as well as ongoing right-side hearing loss. We performed audiological tests, such as pure tone audiometry (PTA), otoacoustic emission, auditory brainstem response (ABR), and auditory steady-state response (ASSR). His clinical and audiological abnormalities disappeared with steroid therapy. However, each test showed different time courses of improvement. Although the results of the PTA and ASSR tests improved in exactly 1 month after the first attack, the results of the ABR reached 3 months to return to normal. To the best of our knowledge, this is the first case report of the time difference of hearing improvement shown in PTA, ASSR, and ABR tests.
Subject(s)
Audiometry, Pure-Tone/methods , Hearing Loss, Sensorineural/diagnosis , Hearing Loss, Sudden/etiology , Multiple Sclerosis/complications , Adult , Cochlear Nerve/pathology , Dizziness/diagnosis , Dizziness/etiology , Evoked Potentials, Auditory/physiology , Hearing/drug effects , Hearing Loss, Sensorineural/drug therapy , Hearing Loss, Sensorineural/physiopathology , Humans , Male , Multiple Sclerosis/physiopathology , Otoacoustic Emissions, Spontaneous/physiology , Steroids/administration & dosage , Steroids/therapeutic use , Treatment OutcomeABSTRACT
BACKGROUND: Extrdural granulation or abscess is a possible complication of chronic suppurative otitis media (CSOM) with cholesteatoma. However, due to development of newer antibiotics and advances in bacteriology and imaging techniques, the incidence of extradural granulation or abscess has significantly decreased. The present study analyzed the clinical presentation, imaging findings, and surgical treatment of eight patients with CSOM with cholesteatoma extending to the cranial fossa. PATIENTS AND METHODS: From 2000 to 2012, 1,010 patients were surgically treated for CSOM with cholesteatoma. Patients with extension to the cranial fossa were studied. Clinical presentation, imaging studies, operative findings, surgical treatment, and postoperative results were evaluated. RESULTS: Twenty cases (1.9%) in a series of 1,010 patients with CSOM with cholesteatoma had bony destruction of the cranial fossa in the temporal bone computed tomography (cr). Of the 20 cases, eight (0.79%) were identified as extradural granulation by magnetic resonance imaging. One patient exhibited nodular enhancement, but it disappeared on preoperative antibiotic treatment. Surgical access for removal of cholesteatoma with extradural granulation was accomplished through canal wall-down tympanomastoidectomy. CONCLUSION: CSOM with cholesteatoma can extend to either the middle or posterior cranial fossa. While CT is sufficient to reveal bony destruction of the cranial fossa, magnetic resonance imaging is required to differentiate and define intracranial extension of CSOM with cholesteatoma.
Subject(s)
Cholesteatoma, Middle Ear/complications , Epidural Abscess/etiology , Epidural Abscess/pathology , Granulation Tissue/pathology , Otitis Media, Suppurative/complications , Adolescent , Adult , Aged , Child , Epidural Abscess/diagnosis , Epidural Abscess/surgery , Female , Follow-Up Studies , Hearing Tests , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Otitis Media, Suppurative/diagnosis , Otitis Media, Suppurative/surgery , Retrospective Studies , Treatment Outcome , Young AdultABSTRACT
Temporal bone fracture and blunt head trauma was once considered as contraindication for the surgery. Increasing numbers of successful cochlear implantation are being reported. However, the outcome of cochlear implantation in severe damaged brain is unclear. A multichannel cochlear implant was successfully implanted in a 33-year-old man who had both sensorineural deafness, left hemiplegia due to bilateral transverse temporal bone fractures and severe right brain damage after a traffic accident.
