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创伤性圆窗和卵圆窗外淋巴瘘4例报告

Traumatic perilymphatic fistula of round and oval windows (four cases reported)

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【作者】 谢鼎华伍伟景卢永德田丰任基浩

【Author】 Xie Dinghua; Wu Weijing; Lu Yongde et al(Department of Otolaryngology,the Second Affiliated Hospital of Hunan MedicalUniversity,Changsha 410011)

【机构】 湖南医科大学附属第二医院耳鼻咽喉科!长沙410011

【摘要】 目的:探讨创伤性圆窗和卵圆窗外淋巴瘘的诊断和治疗。方法:回顾性分析创伤性圆窗和卵圆窗外淋巴瘘4例,其中,手掌击伤耳部2例,砖头击伤头部1例,中耳手术干扰1例。从发病至手术时间为1.5~9个月。通过头和耳部外伤或中耳手术史、听力和前庭功能检查,最后经鼓室探查确诊;用耳屏软骨膜或颞肌筋膜修补外淋巴瘘。结果:4例均经手术探查证实并修补,术后眩晕控制,听力改善不明显。结论:①对于有头部、耳部外伤史或手术后出现不明原因的眩晕、听力受损者应警惕创伤性外淋巴瘘;②对表现为发作性眩晕、波动性听力减退和耳鸣的患者,应注意与梅尼埃病鉴别;③早期手术探查和修复创伤性外淋巴瘘可有效消除眩晕和改善听力。

【Abstract】 Objective:To explore the diagnosis and treatment to traumatic Perilymph fistula (PLF) of roundand oval window. Method:Traumatic PLF was diagnosed by the traumatic history of head,neck and ear,the exa-minations of auditory and vestibular function,and the exploratory tympanotomy. The PLF of round and oval win-dows were repaired by fascia graft or tragus perichondrium and gelform. Four cases with traumatic PLF of roundand oval window were reported in this paper,which included 2 cases hitten by hand, 1 by brick, 1 insulted by niddle ear surgery. Exploratory tympanotomy was performed from one and half to nine months after injury. One casewas misdiagnosed as Meniere’s disease before confirming PLF. Exploration and repair of PLF underwent in allcases. Result:The spoptom of vertigo relieved in all cases after surgery,while the hearing recovery was not evi-dent. Conclusion: ①Traumatic PLF is unrare,hence,traumatic PLF should be alerted if patients suffer from verti-go and hearing impairment after head and ear injury. ②The features with vertigo attacks,fluctuating hearing lossand tinnutis should be distinguished from Meniere’s disease. ③Early exploratory tympanotomy and repair of PLFare effective for relieving vertigo and improving hearing.

  • 【文献出处】 临床耳鼻咽喉科杂志 ,JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY , 编辑部邮箱 ,1999年12期
  • 【分类号】R764
  • 【被引频次】2
  • 【下载频次】42
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