山东大学耳鼻喉眼学报 ›› 2020, Vol. 34 ›› Issue (5): 102-107.doi: 10.6040/j.issn.1673-3770.1.2020.067

• 研究进展 • 上一篇    

耳源性细菌性迷路炎研究进展

魏馨雨1,杨方园1综述杨军2,张青1,2审校   

  1. 魏馨雨1, 杨方园1 综述杨军2, 张青1, 2 审校1.西安交通大学第二附属医院 耳鼻咽喉头颈外科, 陕西 西安 7100042.上海交通大学医学院附属新华医院 耳鼻咽喉头颈外科/上海交通大学医学院耳科学研究所/上海市耳鼻疾病转化医学重点实验室, 上海 200092
  • 收稿日期:2020-07-15 发布日期:2020-11-17
  • 基金资助:
    国家自然基金资助项目(81970891,81670945);陕西省国际合作重点项目(2020KWZ-019);西安交通大学医学院第二附属医院人才培养专项基金[RC(GG)2019]

The progress of otogenic bacterial labyrinthitis research

Labyrinthitis is an infectious disease of the inner ear. Its main clinical manifestations are paroxysmal dizziness, vertigo, and sensorineural hearing loss. This article focuses on the otogenic bacterial labyrinthitis associated with otitis media. According to the pathological manifestations of the inner ear, labyrinthitis can be divided into three types: circumscribed labyrinthitis, serous labyrinthitis, and suppurative labyrinthitis. Circumscribed labyrinthitis, also known as labyrinth fistula, is often complicated by middle ear cholesteatoma, which usually occurs in the horizontal semicircular canal. Serous labyrinthitis is a sterile inflammation in the inner ear caused by bacterial toxins, which often leads to misdiagnosis and misjudgment. Suppurative labyrinthitis is a bacterial infectious inflammation that occurs in the inner ear that often causes severe sensorineural hearing loss and dizziness. At present, otogenic labyrinthitis is no longer rare, although it has not attracted enough attention. This article reviews the different types of otogenic bacterial labyrinthitis in a combination of domestic and foreign literature to provide clinical help for early diagnosis and treatment of patients with this condition.   

  1. Key words: Otitis media;
    Dizziness;
    Vertigo;
    Labyrinthitis;
    Hearing loss
  • Received:2020-07-15 Published:2020-11-17

摘要: 迷路炎是内耳感染性疾病,其主要临床表现包括发作性头晕、眩晕与感音神经性听力损失。探讨与中耳炎相关的耳源性细菌性迷路炎。根据内耳的病理表现,可以将迷路炎分为局限性迷路炎、浆液性迷路炎和化脓性迷路炎三种。局限性迷路炎也叫做迷路瘘管,常并发于中耳胆脂瘤,好发于水平半规管;浆液性迷路炎是细菌毒素所致的内耳无菌性炎症,常因发病隐袭与其他头晕眩晕疾病混淆造成误诊误判;化脓性迷路炎是发生于内耳的细菌感染性炎症,常造成严重的感音性听力损失和眩晕。目前耳科临床迷路炎并不少见,但并未引起足够的重视。论文结合国内外文献对不同类型的耳源性细菌性迷路炎进行综述,以期为临床对此类患者早诊断早治疗提供帮助。

关键词: 中耳炎, 头晕, 眩晕, 迷路炎, 听力丧失

Abstract: Labyrinthitis is an infectious disease of the inner ear. Its main clinical manifestations are paroxysmal dizziness, vertigo, and sensorineural hearing loss. This article focuses on the otogenic bacterial labyrinthitis associated with otitis media. According to the pathological manifestations of the inner ear, labyrinthitis can be divided into three types: circumscribed labyrinthitis, serous labyrinthitis, and suppurative labyrinthitis. Circumscribed labyrinthitis, also known as labyrinth fistula, is often complicated by middle ear cholesteatoma, which usually occurs in the horizontal semicircular canal. Serous labyrinthitis is a sterile inflammation in the inner ear caused by bacterial toxins, which often leads to misdiagnosis and misjudgment. Suppurative labyrinthitis is a bacterial infectious inflammation that occurs in the inner ear that often causes severe sensorineural hearing loss and dizziness. At present, otogenic labyrinthitis is no longer rare, although it has not attracted enough attention. This article reviews the different types of otogenic bacterial labyrinthitis in a combination of domestic and foreign literature to provide clinical help for early diagnosis and treatment of patients with this condition.

Key words: Otitis media, Dizziness, Vertigo, Labyrinthitis, Hearing loss

中图分类号: 

  • R764.43
[1] Anniko M, Bernal-Sprekelsen M, Bonkowsky V, et al. Otorhinolaryngology, Head and Neck Surgery[M]. Springer Verlag, 2010: 106-109.
[2] Ruckenstein MJ.Vertigo and disequilibrium with associated hearing loss[J]. Otolaryngol Clin North Am, 2000, 33(3):535-562. doi:10.1016/s0030-6665(05)70226-7.
[3] Sone M, Yoshida T, Naganawa S, et al. Comparison of computed tomography and magnetic resonance imaging for evaluation of cholesteatoma with labyrinthine fistulae[J]. The Laryngoscope, 2012, 122(5): 1121-1125. doi:10.1002/lary.23204.
[4] West CE, Scott S. The Operative Surgery of Labyrinthitis, based upon an experience of thirty cases[J]. Proceedings of the Royal Society of Medicine, 1908, 1(Otol Sect):37-83.
[5] Turner AL, Fraser JS. Labyrinthitis, a complication of middle ear suppuration: a clinical and pathological study[J]. Proceedings of the Royal Society of Medicine, 1932, 25(9):1478-1486.
[6] Kangsanarak J, Fooanant S, Ruckphaopunt K, et al. Extracranial and intracranial complications of suppurative otitis media. Report of 102 cases[J]. The Journal of Laryngology and Otology, 1993, 107(11):999-1004. doi:10.1017/s0022215100125095.
[7] Osma U, Cureoglu S, Hosoglu S. The complications of chronic otitis media: report of 93 cases[J]. J Laryngol Otol, 2000, 114(2):97-100. doi:10.1258/0022215001905012.
[8] Paparella MM, Sugiura S. XLIV the pathology of suppurative labyrinthitis[J]. Ann Otol Rhinol Laryngol, 1967, 76(3):554-586. doi:10.1177/000348946707600303.
[9] Hillman, Todd. Ballengers Otorhinolaryngology Head and Neck Surgery[M]. Sixteenth Edition, Otology & Neurotology, Peoples Medical Publishing House, 2003, 24(2):262.
[10] 黄选兆. 实用耳鼻咽喉头颈外科学[M]. 北京:人民卫生出版社, 2008:912-915.
[11] Rah YC, Han WG, Joo JW, et al. One-stage complete resection of cholesteatoma with labyrinthine fistula: hearing changes and clinical outcomes[J]. Ann Otol Rhinol Laryngol, 2018, 127(4):241-248. doi:10.1177/0003489418755407.
[12] Gersdorff MC, Nouwen J, Decat M, et al. Labyrinthine fistula after cholesteatomatous chronic otitis media[J]. Am J Otol, 2000, 21(1):32-35.
[13] Sone M, Yoshida T, Naganawa S, et al. Comparison of computed tomography and magnetic resonance imaging for evaluation of cholesteatoma with labyrinthine fistulae[J]. The Laryngoscope, 2012, 122(5):1121-1125. doi:10.1002/lary.23204.
[14] Meyer A, Bouchetemblé P, Costentin B, et al. Lateral semicircular canal fistula in cholesteatoma: diagnosis and management[J]. Eur Arch Otorhinolaryngol, 2016, 273(8):2055-2063. doi:10.1007/s00405-015-3775-6.
[15] Dornhoffer J, Milewski C. Management of the open labyrinth[J]. Otolaryngol-Head Neck Surg, 1995, 112(3):410-414. doi:10.1016/s0194-5998(95)70275-x.
[16] Gocea A, Martinez-Vidal B, Panuschka C, et al. Preserving bone conduction in patients with labyrinthine fistula[J]. Eur Arch Otorhinolaryngol,2012, 269(4):1085-1090. doi:10.1007/s00405-011-1757-x.
[17] Geerse S, de Wolf MJF, Ebbens FA, et al. Management of labyrinthine fistula: hearing preservation versus prevention of residual disease[J]. Eur Arch Otorhinolaryngol, 2017, 274(10):3605-3612. doi:10.1007/s00405-017-4697-2.
[18] Cureoglu S, Schachern PA, Rinaldo A, et al. Round window membrane and labyrinthine pathological changes: an overview[J]. Acta Oto-Laryngol, 2005, 125(1):9-15. doi:10.1080/00016480410022534.
[19] Dobrianskyj FM, Dias Gonçalves ÍR, Tamaoki Y, et al. Correlation between sensorineural hearing loss and chronic otorrhea[J]. Ear Nose Throat J, 2019, 98(8):482-485. doi:10.1177/0145561319840573.
[20] Dommaraju S, Perera E. An approach to Vertigo in general practice[J]. Australian Family Physician, 2016, 45(4):190-194.
[21] Choi JW, Han K, Nahm H, et al. Direction-changing positional nystagmus in acute otitis media complicated by serous labyrinthitis: new insights into positional nystagmus[J]. Otol Neurotol, 2019, 40(4):e393-e398. doi:10.1097/mao.0000000000002104.
[22] Kim CH, Yang YS, Im D, et al. Nystagmus in patients with unilateral acute otitis media complicated by serous labyrinthitis[J]. Acta Oto-Laryngologica, 2016, 136(6):559-563. doi:10.3109/00016489.2015.1132845.
[23] Choi JW, Han K, Nahm H, et al. Direction-changing positional nystagmus in acute otitis media complicated by serous labyrinthitis: new insights into positional nystagmus[J]. And, 2019, 40(4):e393-e398. doi:10.1097/MAO.0000000000002104.
[24] Cadoni G, Cianfoni A, Agostino S, et al. Magnetic resonance imaging findings in sudden sensorineural hearing loss[J]. J Otolaryngol, 2006, 35(5):310-316. doi: 10.2310/7070.2006.0066.
[25] Kitsko DJ, Dohar JE. Inner ear and facial nerve complications of acute otitis media, including Vertigo[J]. Current Allergy and Asthma Reports, 2007, 7(6):444-450. doi:10.1007/s11882-007-0068-1.
[26] Kaya S, Tsuprun V, Hızlı Ö, et al. Cochlear changes in serous labyrinthitis associated with silent otitis media: a human temporal bone study[J]. American Journal of Otolaryngology, 2016, 37(2):83-88. doi:10.1016/j.amjoto.2015.10.002.
[27] de Souza C, Paparella MM, Schachern P, et al. Pathology of labyrinthine ossification[J]. The Journal of Laryngology and Otology, 1991, 105(8):621-624. doi:10.1017/s0022215100116846.
[28] Arriaga MA. Schuknechts pathology of the ear, third edition[J]. Otol Neurotol, 2011, 32(7):1039. doi:10.1097/mao.0b013e31821f16c4.
[29] Maranhão AS, Godofredo VR, Penido Nde O. Suppurative labyrinthitis associated with otitis media: 26 years experience[J]. Brazilian Journal of Otorhinolaryngology, 2016, 82(1):82-87. doi:10.1016/j.bjorl.2014.12.012.
[30] Kaya S, Schachern PA, Tsuprun V, et al. Deterioration of vestibular cells in labyrinthitis[J]. The Annals of Otology, Rhinology, and Laryngology, 2017, 126(2):89-95. doi:10.1177/0003489416675356.
[31] Lin HY, Fan YK, Wu KC, et al. The incidence of tympanogenic labyrinthitis ossificans[J]. The Journal of Laryngology and Otology, 2014, 128(7):618-620. doi:10.1017/S002221511400111X.
[32] Buch K, Baylosis B, Fujita A, et al. Etiology-specific mineralization patterns in patients with labyrinthitis ossificans[J]. AJNR Am J Neuroradiol, 2019, 40(3):551-557. doi:10.3174/ajnr.A5985.
[33] Kaya S, Paparella MM, Cureoglu S. Pathologic findings of the cochlea in labyrinthitis ossificans associated with the round window membrane[J]. Otolaryngol Head Neck Surg, 2016, 155(4):635-640. doi:10.1177/0194599816651245.
[34] Kaya S, Tsuprun V, Hizli Ö, et al. Quantitative assessment of cochlear histopathologic findings in patients with suppurative labyrinthitis[J]. JAMA Otolaryngology-Head & Neck Surgery, 2016, 142(4):364-369. doi:10.1001/jamaoto.2015.3803.
[35] Booth TN, Roland P, Kutz JW Jr, et al. High-resolution 3-D T2-weighted imaging in the diagnosis of labyrinthitis ossificans: emphasis on subtle cochlear involvement[J]. Pediatric Radiology, 2013, 43(12):1584-1590. doi:10.1007/s00247-013-2747-5.
[36] Huang BY, Zdanski C, Castillo M. Pediatric sensorineural hearing loss, part 2: syndromic and acquired causes[J]. American Journal of Neuroradiology, 2012, 33(3):399-406. doi: 10.3174/ajnr.A2499.
[37] Lemmerling MM, De Foer B, Verbist BM, et al. Imaging of inflammatory and infectious diseases in the temporal bone[J]. Neuroimaging Clinics Of North America. 2009,19(3):321-337. doi: 10.1016/j.nic.2009.06.006.
[38] Kopelovich JC, Germiller JA, Laury AM, et al. Early prediction of postmeningitic hearing loss in children using magnetic resonance imaging[J]. Archives of Otolaryngology-Head and Neck Surgery. 2011,137(5):441-447. doi: 10.1001/archoto.2011.13.
[39] Lin YS. Clinical outcomes of scala vestibuli cochlear implantation in children with partial labyrinthine ossification[J]. Acta Oto-Laryngologica. 2009,129(3):273-280. doi: 10.1080/00016480802032819.
[40] Isaacson B, Booth T, Kutz JW Jr, et al. Labyrinthitis ossificans: how accurate is MRI in predicting cochlear obstruction[J]. Otolaryngol Head Neck Surg, 2009,140(5):692-696. doi: 10.1016/j.otohns.2008.12.029.
[1] 杨军,郑贵亮. 外周前庭疾病的诊断和治疗[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 1-6.
[2] 刘宇鹏,梁敏,何景春,郑贵亮,李姝娜,张青,杨军. 梅尼埃病前庭功能分级的探讨[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 14-19.
[3] 刘宇鹏,吴文瑾,何景春,郑贵亮,张青,杨军. 迷路后径路前庭神经切断术治疗难治性梅尼埃病75例[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 46-50.
[4] 陈建勇, 孙夏雨, 沈佳丽, 汪玮, 王璐, 贺宽, 张勤, 马孝宝, 沈敏, 陈向平, 杨军. 原发性良性阵发性位置性眩晕患者VEMP异常率的临床观察[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 51-55.
[5] 邓巧媚,王巍,温超,刘强,毛翔,韩曦,李姗姗,陈太生,徐开旭,林鹏. 头晕眩晕与眼震强度的关系研究[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 56-60.
[6] 王海霞,张彩霞,李银银,郑金秀,陈曦. 经鼓室注射内耳钆造影显影不良原因初探[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 61-66.
[7] 郑贵亮, 刘凌峰, 陈建勇, 张青, 杨军. 基于移动互联网的前庭康复训练指导平台的开发与应用[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 78-81.
[8] 赵欢娣,成颖综述杨军,张青审校. 3D-FLAIR MRI在内耳出血所致的SSNHL诊断中的作用[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 97-101.
[9] 伊海金,杨仕明. 重视耳部外伤诊疗工作[J]. 山东大学耳鼻喉眼学报, 2020, 34(1): 1-3.
[10] 许嘉,伊海金. 正确处理颞骨骨折耳科并发症[J]. 山东大学耳鼻喉眼学报, 2020, 34(1): 4-8.
[11] 许玲综述孙岩审校. 三叶因子家族在中耳呼吸型黏膜上皮的研究进展[J]. 山东大学耳鼻喉眼学报, 2020, 34(1): 93-98.
[12] 陈太生, 王巍, 徐开旭, 林鹏. 良性阵发性位置性眩晕及其诊断治疗的思考[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 1-5.
[13] 谢慧. 眩晕的中医认识[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 11-17.
[14] 张玥琦, 邓巧媚, 王巍, 徐开旭, 温超, 刘强, 陈太生, 林鹏. 眩晕头晕主诉患者中良性阵发性位置性眩晕的占比分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 18-21.
[15] 邓巧媚, 张玥琦, 王巍, 徐开旭, 温超, 刘强, 陈太生, 林鹏. 良性阵发性位置性眩晕与合并疾病的关联性分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 22-25.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!