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A case of tympanogenic labyrinthitis complicated by acute otitis media.

Jang CH, Park SY, Wang PC - Yonsei Med. J. (2005)

Bottom Line: MRI was helpful to identify the inflammatory change of the membranous labyrinth.The patient's hearing returned to normal after treatment.The definite diagnosis of serous labyrinthitis was established retrospectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology, Chonnam National University Hospital, 8 Hak- dong, Dong-gu, Gwangju, Chonbuk 570-711, Korea. chulsavio@hanmail.net

ABSTRACT
Widespread use of antimicrobial drugs in the management of otitis media has significantly reduced the incidence of labyrinthitis nowadays. Cases of tympanogenic labyrinthitis following acute otitis media have rarely been reported in recent literature on otolaryngology. We report an unusual case of tympanogenic labyrinthitis that presented with sudden sensorineural hearing loss (SNHL) following acute otitis media in an adult who had no previous otological complaints. An audiogram revealed SNHL with pure tone threshold of 43.7 dB in the left ear. MRI was helpful to identify the inflammatory change of the membranous labyrinth. The patient's hearing returned to normal after treatment. The definite diagnosis of serous labyrinthitis was established retrospectively.

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Related in: MedlinePlus

Pure tone audiogram revealed an improvement with pure tone threshold 25 dB in the left ear at 9th day following steroid treatment.
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Figure 3: Pure tone audiogram revealed an improvement with pure tone threshold 25 dB in the left ear at 9th day following steroid treatment.

Mentions: The patient underwent myringotomy and insertion of ventilation tube. The purulent secretion drained from the middle ear was sent for culture. Although the culture demonstrated no growth of microorganisms, she was initially treated with intratympanic instillation of ciprofloxacin drops and put on intravenous cephalosporin (Meicelin®) injection for one week. The ECG, chest radiograph and laboratory studies were unremarkable. However, the symptoms of tinnitus and hearing loss were not resolved despite the parenteral antibiotic treatment. Under the impression of possible labyrinthitis, 5-day oral steroid treatment with prednisone (69 mg/d) was started on the 8th day after admission and was tapered off between days 10 and 12. Six days after the commencement of steroid treatment, objective improvement in hearing was first noted, and the patient was discharged. At first outpatient check-up 9 days after the commencement of steroid treatment, dramatic improvement was detected with pure tone threshold returning to 25 dB (Fig. 3). Her hearing had returned to normal at all frequencies except 8 kHz. Tinnitus continued to subside over the subsequent 1 month of outpatient follow-up (Fig. 4). Post-treatment MRI was not obtained owing to the patient's refusal off follow-up examination.


A case of tympanogenic labyrinthitis complicated by acute otitis media.

Jang CH, Park SY, Wang PC - Yonsei Med. J. (2005)

Pure tone audiogram revealed an improvement with pure tone threshold 25 dB in the left ear at 9th day following steroid treatment.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2823044&req=5

Figure 3: Pure tone audiogram revealed an improvement with pure tone threshold 25 dB in the left ear at 9th day following steroid treatment.
Mentions: The patient underwent myringotomy and insertion of ventilation tube. The purulent secretion drained from the middle ear was sent for culture. Although the culture demonstrated no growth of microorganisms, she was initially treated with intratympanic instillation of ciprofloxacin drops and put on intravenous cephalosporin (Meicelin®) injection for one week. The ECG, chest radiograph and laboratory studies were unremarkable. However, the symptoms of tinnitus and hearing loss were not resolved despite the parenteral antibiotic treatment. Under the impression of possible labyrinthitis, 5-day oral steroid treatment with prednisone (69 mg/d) was started on the 8th day after admission and was tapered off between days 10 and 12. Six days after the commencement of steroid treatment, objective improvement in hearing was first noted, and the patient was discharged. At first outpatient check-up 9 days after the commencement of steroid treatment, dramatic improvement was detected with pure tone threshold returning to 25 dB (Fig. 3). Her hearing had returned to normal at all frequencies except 8 kHz. Tinnitus continued to subside over the subsequent 1 month of outpatient follow-up (Fig. 4). Post-treatment MRI was not obtained owing to the patient's refusal off follow-up examination.

Bottom Line: MRI was helpful to identify the inflammatory change of the membranous labyrinth.The patient's hearing returned to normal after treatment.The definite diagnosis of serous labyrinthitis was established retrospectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology, Chonnam National University Hospital, 8 Hak- dong, Dong-gu, Gwangju, Chonbuk 570-711, Korea. chulsavio@hanmail.net

ABSTRACT
Widespread use of antimicrobial drugs in the management of otitis media has significantly reduced the incidence of labyrinthitis nowadays. Cases of tympanogenic labyrinthitis following acute otitis media have rarely been reported in recent literature on otolaryngology. We report an unusual case of tympanogenic labyrinthitis that presented with sudden sensorineural hearing loss (SNHL) following acute otitis media in an adult who had no previous otological complaints. An audiogram revealed SNHL with pure tone threshold of 43.7 dB in the left ear. MRI was helpful to identify the inflammatory change of the membranous labyrinth. The patient's hearing returned to normal after treatment. The definite diagnosis of serous labyrinthitis was established retrospectively.

Show MeSH
Related in: MedlinePlus