본문 바로가기
KERD
논문KCI 등재

이낭 침범성 측두골 골절에 동반된 내이기종의 진단과 임상양상

Pneumolabyrinth Associated with Otic Capsule-Violating Fracture: Diagnosis and Clinical Features

2

조회

0

다운로드

1

인용

0

참고문헌

주제분류이비인후과학

초록

Pneumolabyrinth, the presence of air in the inner ear is an evidence of a pathological connection between the fluid-filled space of inner ear and the air-filled space of mastoid/middle ear cavity. The aim of this study is to evaluate the clinical characteristics of pneumolabyrinth combined with temporal bone fracture. Subjects and Method:Among 51 patients with temporal bone fracture, those who visited a secondary referral center between January 2005 to March 2008, 6 patients (7 ears, one bilateral case) with pneumolabyrinth were selected for a retrospective review on their medical records and radiologic findings. Results:All six patients were male, and had concomitant otic capsule-violating fracture in the affected side. All pneumolabyrinths were diagnosed in the CT images taken on the date of trauma, and in one case, the pneumolabyrinth disappeared in a follow- up CT which was taken after 5 days. Six affected ears out of 5 patients showed profound sensorineural hearing loss and one patient with down-sloping severe sensorineural hearing loss showed partial recovery of hearing threshold a month later. Vestibular function tests were performed in four cases and vestibular weaknesses were identified in all affected ears. Conclusion:Immediate high-resolution CT might improve the detection rate of pneumolabyrinth combined with temporal bone fracture. Otic capsule- disrupting fracture has been considered to be synonymous with irreversibly severe to profound sensorineural hearing loss, but one case showed partial recovery in this study. Follow-up audiometric tests are needed to check the recovery of hearing threshold. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:1081-7)

Abstract

Pneumolabyrinth, the presence of air in the inner ear is an evidence of a pathological connection between the fluid-filled space of inner ear and the air-filled space of mastoid/middle ear cavity. The aim of this study is to evaluate the clinical characteristics of pneumolabyrinth combined with temporal bone fracture. Subjects and Method:Among 51 patients with temporal bone fracture, those who visited a secondary referral center between January 2005 to March 2008, 6 patients (7 ears, one bilateral case) with pneumolabyrinth were selected for a retrospective review on their medical records and radiologic findings. Results:All six patients were male, and had concomitant otic capsule-violating fracture in the affected side. All pneumolabyrinths were diagnosed in the CT images taken on the date of trauma, and in one case, the pneumolabyrinth disappeared in a follow- up CT which was taken after 5 days. Six affected ears out of 5 patients showed profound sensorineural hearing loss and one patient with down-sloping severe sensorineural hearing loss showed partial recovery of hearing threshold a month later. Vestibular function tests were performed in four cases and vestibular weaknesses were identified in all affected ears. Conclusion:Immediate high-resolution CT might improve the detection rate of pneumolabyrinth combined with temporal bone fracture. Otic capsule- disrupting fracture has been considered to be synonymous with irreversibly severe to profound sensorineural hearing loss, but one case showed partial recovery in this study. Follow-up audiometric tests are needed to check the recovery of hearing threshold. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:1081-7)

참고문헌 (21)

  1. 현도진, "측두골 골절에 합병된 내이기종 1예", 대한이비인후과학회지 두경부외과학, 49(10), pp.1021~1023 (2006), 대한이비인후과학회
  2. Gross M, "Pneumolabyrinth: An unusual finding in a temporal bone fracture", Int J Pediatr Otorhinolaryngol, 67(5), pp.553~555 (2003)
  3. Woo HJ, "Pneumolabyrinth without temporal bone fracture: Different outcomes for hearing recovery", Laryngoscope, 118(8), pp.1464~1466 (2008)
  4. McGhee MA, "A case of barotrauma-induced pneumolabyrinth secondary to perilymphatic fistula", Ear Nose Throat J, 79(6), pp.456~459 (2000)
  5. Park SY, "Pneumolabyrinth: Definitive sign of traumatic perilymph fistula", Korean J Audiol, 2(2), pp.190~193 (1998)
  6. Lao WW, "Assessment of changes in cochlear function with pneumolabyrinth after middle ear trauma", Otol Neurotol, 28(8), pp.1013~1017 (2007)
  7. Mafee MF, "Computed tomography of the middle ear in the evaluation of choles teatomas and other soft-tissue masses: Comparison with pluridirectional tomography", Radiology, 148(2), pp.465~472 (1983)
  8. Stone JA, "CT evaluation of prosthetic ossicular reconstruction procedures: What the otologist needs to know", Radiographics, 20(3), pp.593~605 (2000)
  9. Scheid SC, "Pneumolabyrinth: A late complication of stapes surgery", Ear Nose Throat J, 80(10), pp.750~753 (2001)
  10. Hempel JM, "Labyrinth dysfunction 8 months after cochlear implantation: A case report", Otol Neurotol, 25(5), pp.727~729 (2004)
  11. Dahiya R, "Temporal bone fractures: Otic capsule sparing versus otic capsule violating clinical and radiographic considerations", J Trauma, 47(6), pp.1079~1083 (1999)
  12. Little SC, "Radiographic classification of temporal bone fractures: Clinical predictability using a new system", Arch Otolaryngol Head Neck Surg, 132(12), pp.1300~1304 (2006)
  13. 문석균, "외상에 의하여 발생된 내이기종 2예", 대한이비인후과학회지 두경부외과학, 51(3), pp.273~277 (2008), 대한이비인후과학회
  14. Shin MC, "CI implant after bilateral transverse temporal bone fracture with total hearing loss (poster number: SEP-29)", Presented at the 82nd Congress of Korean Society of Otorhinolaryngology-Head and Neck Surgery, pp.25~27 (2008)
  15. Kobayashi T, "Effect of perilymphatic air perfusion on cochlear potentials", Acta Otolaryngol, 110(3), pp.209~216 (1990)
  16. Foster PK, "A model for perilymphatic fistula induced hearing loss in the guinea pig cochlea", Hear Res, 167(1), pp.175~179 (2002)
  17. Woodson EA, "Bilateral pneumolabyrinth diagnostic for otic capsule fractures without high-resolution imaging", Otolaryngol Head Neck Surg, 137(6), pp.969~971 (2007)
  18. Weissman JL, "Pneumolabyrinth: A computed tomographic sign of temporal bone fracture", Am J Otolaryngol, 13(2), pp.113~114 (1992)
  19. Lee SH, "A case of pneumolabyrinth after head trauma", Korean J Audiol, 11(2), pp.139~142 (2007)
  20. Lyos AT, "Progressive hearing loss after transverse temporal bone fracture", Arch Otolaryngol Head Neck Surg, 121(7), pp.795~799 (1995)
  21. Kahn JB, "Acute temporal bone trauma: Utility of high-resolution computed tomography", Am J Otol, 21(5), pp.743~752 (2000)

관련 논문AI추천

이 간행물의 다른 논문 (9건)