Suppurative labyrinthitis associated with otitis media: 26 years' experience

ABSTRACT INTRODUCTION: Suppurative labyrinthitis continues to result in significant hearing impairment, despite scientific efforts to improve not only its diagnosis but also its treatment. The definitive diagnosis depends on imaging of the inner ear, but it is usually clinically presumed. OBJECTIVE: To analyze the clinical factors and hearing outcomes in patients with labyrinthitis secondary to middle ear infections and to discuss findings based on imaging test results. METHODS: Retrospective cohort study, based on the charts of patients admitted with middle ear infection-associated labyrinthitis. RESULTS: We identified 14 patients, eight (57%) of whom were females and six (43%) males. Mean age was 40 years. Cholesteatomatous chronic otitis media was diagnosed in six patients (43%), acute suppurative otitis media in six (43%), and chronic otitis media without cholesteatoma was diagnosed in two patients (14%). Besides labyrinthitis, 24 concomitant complications were identified: six cases (25%) of labyrinthine fistula, five cases (21%) of meningitis, five cases (21%) of facial paralysis, five cases (21%) of mastoiditis, two cases (8%) of cerebellar abscess, and one case (4%) of temporal abscess. There was one death. Eight (57%) individuals became deaf, while six (43%) acquired mixed hearing loss. CONCLUSION: Suppurative labyrinthitis was often associated with other complications; MRI played a role in the definitive diagnosis in the acute phase; the hearing sequel of labyrinthitis was significant.引言：尽管学界已在化脓性迷路炎的诊断与治疗领域开展了诸多探索，但该病仍会造成严重的听力损伤。其确诊需依赖内耳影像学检查，但临床中通常仅依靠经验推定。研究目的：分析继发于中耳感染的迷路炎患者的临床相关因素与听力转归，并结合影像学检查结果对相关发现进行探讨。研究方法：本研究为回顾性队列研究，基于因中耳感染相关性迷路炎入院患者的病历资料开展。研究结果：本研究共纳入14例患者，其中男性6例（占比43%）、女性8例（占比57%），平均年龄为40岁。6例（43%）患者被诊断为伴胆脂瘤的慢性中耳炎，6例（43%）为急性化脓性中耳炎，2例（14%）为不伴胆脂瘤的慢性中耳炎。除迷路炎外，共发现24例次伴随并发症：6例（25%）出现迷路瘘管，5例（21%）并发脑膜炎，5例（21%）出现面神经麻痹，5例（21%）罹患乳突炎，2例（8%）出现小脑脓肿，1例（4%）出现颞部脓肿；另有1例患者死亡。8例（57%）患者出现耳聋，6例（43%）出现混合性听力损失。研究结论：化脓性迷路炎常伴随其他多种并发症；磁共振成像（MRI）在急性期确诊中具有重要价值；迷路炎所致的听力后遗症较为显著。