Sudden hearing loss in a patient with a 3-mm acoustic tumor

Yıl 2007, Cilt: 17 Sayı: 2, 120 - 125, 18.03.2007

İsmail Yılmaz Hatice Seyra Erbek Selim Erbek Özlem Ulusoy Tarkan Çalışaneller

Öz

Sudden sensorineural hearing loss SNHL accounts for 1% of ali SNHL cases. İt has been reported that acoustic neuroma may be present up to 47.5% of patients with sudden SNHL. A 55-year-old man pre- sented with sudden hearing loss in his left ear of 45-day history. Audiologic and transient evoked otoacoustic emission tests showed near-total hearing loss and absence of emissions in the left ear, respectively.Electronystagmography showed left canal paralysis and lack of response to the Kobrak test. The interpeak interval l-V latency and interaural amplitude differences in wave V latency were prolonged in auditory brainstem response. Computed tomography showed an increase in the diameter of the left internal acoustic canal, and magnetic resonance imaging MRI revealed an intra- canalicular mass, 3 mm in size, originating from the left cochlear nerve. Another mass 18x17 mm was detect- ed that filled the right pontocerebellar cistern, suggest- ing a meningioma, but this was not thought to exert an obvious shift effect contributing to the development of left-sided hearing loss. Despite treatment with a tapered course of fluocortolone for 18 days the patient’s hearing level did not change. He was included in a follow-up with MRI at six-month intervals.

Anahtar Kelimeler

Hearing loss, sensorineural/etiology, neuro­ma, acoustic/complications

Uç milimetrelik akustik tümörü olan bir hastada ani işitme kaybı

Öz

Ani sensörinöral işitme kaybı SNİK tüm SNİK’li olgu- ların yaklaşık %1’ini oluşturur. Ani SNİK’li hastalarda akustik nörinom görülme oranı %47.5’e kadar bildiril- miştir. Sol kulağında 45 gün önce aniden başlayan işit- me kaybı nedeniyle başvuran 55 yaşında erkek hasta- nın odyolojik inceleme ve geçici uyarılmış otoakustik emisyonunda solda tamama yakın SNİK ve emisyon yokluğu görüldü. Elektronistagmografide solda kanal paralizisi ve Kobrak testine yanıtsızlık; işitsel beyin sa- pı odyometrisinde sol I-V interpik latansında ve V. dal- ga latans süresinin kulaklar arası farkında uzama; iç kulak bilgisayarlı tomografisinde sol internal akustik kanal İAK çapında genişleme görüldü ve İAK manye- tik rezonans görüntülemede MRG solda intrakanali- küler 3 mm çaplı koklear sinir kökenli kitleye rastlandı. Hastada aynı zamanda saptanan, sağ pontoserebellar sisterni dolduran, 18x17 mm boyutlarında menenjiyom ile uyumlu ikinci bir kitlenin belirgin kayma etkisi yarat- madığı, dolayısıyla soldaki işitme kaybının gelişmesi- ne katkısının olmadığı düşünüldü. Ani işitme kaybın- dan sonra geç başvuran hastaya, 18 günlük azalan dozda fluokortolon verilmesine rağmen işitme eşikle- rinde değişiklik olmadı ve hasta altı ay aralarla çekile- cek MRG incelemeleriyle izleme alındı

Anahtar Kelimeler

İşitme kaybı, sensörinöral/etyoloji, akustik nöroma/komplikasyon

Kaynakça

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