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Sudden Sensorineural Hearing Loss after Pituitary Adenoma Resection-A Case Series with Literature Review

Chinese Medical Sciences Journal 2021年第2期36卷 120-126页

作者： Yi Wang Zhuhua Zhang Wei Lian Department of Otolaryngology Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China Department of Clinical Radiology Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China Department of Neurosurgery Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China

Objective Complications after transsphenoidal surgery for pituitary adenoma have been well documented in the literatures,but the occurrence of delved sudden sensorineural hearing loss(SNHL)after pituitary adenoma resection is extremely rare.In this study three cases who developed sudden SNHL 3 to 7 days after pituitary adenoma surgery without experiencing cerebrospinal fluid leak or meningitis were presented,and the possible causes of SNHL were discussed.Methods Three cases with sudden hearing loss after transsphenoidal surgery for pituitary adenoma were reviewed.The past medical history,onset of sudden hearing loss,accompanying symptoms such as headache,tinnitus,dizziness and aural fullness,and the post-operative MRI images,therapy and hearing results were reported.Results Three cases developed profound sudden SNHL on the 3rd to 7th post-operative day,all accompanied by prior headache,tinnitus and dizziness.One patient developed episodic vertigo,ear fullness accompanying with fluctuating hearing loss in the first post-operative month.Two patients had past medical history of arteriosclerosis and coronary heart disease or cerebral infarction.Two of three demonstrated obstructive hydrocephalus on MRI on the first post-operative day.Under treatment with prednisone orally,dexamethasone intratympanic mjection,neurotrophic and vasodilatation drugs for 3 to 8 months,hearing of all three improved partially.obstructive hydrocephalus and ischemia might be responsible for the hearing loss.Conclusion Post-operative obstructive hydrocephalus and ischemia of labyrinthine arteries might lead to the delayed SNHL after transsphenoidal surgery for pituitary adenoma.

关键词： transsphenoidal surgery for pituitary adenoma obstructive hydrocephalus ischemia of internal auditory arteries sudden sensorineural hearing loss tinnitus

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Endoscopic Third Ventriculostomy Guided by CISS MRI for Obstructed hydrocephalus

Endoscopic Third Ventriculostomy Guided by CISS MRI for Obst...

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2011年浙江省神经外科学学术年会

作者： Department of Neurosurgery 2nd Affiliated Hospital School of Medicine Zhejiang University Hangzhou 310009 China Shi Jian,MD Zhang Hong,MD Fu Weiming,MD

Background Endoscopic third ventriculostomy(ETV) is a developing therapeutic stratagem for obstructive hydrocephalus(OH).The aim of this study was to determine the significance of third ventricle diagnostic analysis in OH patients by three dimensional constructive inference in steady state(3D CISS) sequence magnetic resonance imagination(MRI) and the clinical value of this technique in preoperative and postoperative patients who accepted endoscopic third ventriculostomy(ETV). Methods Forty-six patients underwent 3D CISS sequence MRI on a 1.5T superconductive MR unit,whose ventricle system were demonstrated existing obstruction below post-part of third ventricle in this retrospective study,and 12 cases in them accepted ETV therapy.Regression analysis of correlative degree between third ventricle enlargement(TVE,ratio of maximum width of third ventricle to the maximum width of the inner table of the cranium) and hydrocephalus degree(EVANS Index:ratio of maximum width of the frontal horns to the maximum width of the inner table of the cranium),and between TVE and third ventricle floor thickness (TVFT) were completed.In 12 EVT cases,the incisions were marked according MR images,and the 3D-CISS sequence imaging and the surgical outcome were compared before and after ETV.Results With the help of 3D-CISS,97.83%third ventricle floors and 91.30%basilar arteries(BA) could be showed,and there was an obvious positive correlativity between TVE and EVANS Index and a negative correlativity between TVE and TVFT in this group.All incisions on the scalp could be marked correctly.Preoperatively,the enlargement degree of third ventricle and the easiness or difficulty of puncturing third ventricle floor could be evaluated.Orientation of BA could be found out to avoid iatrogenic trauma in operation.At follow-up,100%fistulas of third ventricle floor could be measured on 3D-CISS images,mean diameter(mm) was 6.12±0.96,91.67%new CSF fluid direction could be demonstrated,83.33%enlarged ventricle system got withdrew,and 91.67%patients obtai

关键词： obstructive hydrocephalus Third Ventricle Endoscopic third Ventriculostomy MRI

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Endoscopic Third Ventriculostomy guided by CISS MRI for Obstructed hydrocephalusbefore and after CISS Sequence in the

Endoscopic Third Ventriculostomy guided by CISS MRI for Obst...

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中华医学会神经外科学分会第九次学术会议

作者：石键张宏浙江大学医学院附属第二医院神经外科

Background:Endoscopic third ventriculostomy(ETV)is a developing therapeutic stratagem for obstructive hydrocephalus (OH).The aim of this study was to determine the significance of third ventricle diagnostic analysis in OH patients by three dimensional constructive inference in steady state(3D CISS)sequence magnetic resonance imagination(MRI)and the

关键词： obstructive hydrocephalus Third Ventricle Endoscopic third Ventriculostomy MRI

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Endoscopic Third Ventriculostomy guided by CISS MRI for Obstructed hydrocephalus before and after CISS Sequence in th

Endoscopic Third Ventriculostomy guided by CISS MRI for Obst...

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2011中华医学会神经外科学学术会议

作者： Jian Shi1 Hong Zhang1 Weiming Fu1 1.Department of Neurosurgery 2 nd Affiliated Hospital School of Medicine Zhejiang University Hangzhou 3 1 0009 China

关键词： obstructive hydrocephalus Third Ventricle Endoscopic third Ventriculostomy MRI

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