圆窗和卵圆窗加固术治疗外伤性上半规管骨折

The Treatment of Traumatic Superior Semicircular Canal Fracture using Round and Oval Window Reinforcements

邹静;郑宏良;高颖娜;彭日顺子;郑贵亮;

1:第二军医大学长海医院耳鼻咽喉头颈外科全军耳鼻咽喉头颈外科中心

2:Hearing and Balance Research Unit

3:Field of Otolaryngology

4:School of Medicine

摘要
目的探讨圆窗和卵圆窗加固术治疗外伤性上半规管骨折引发的前庭功能障碍的手术方法及效果。方法回顾性分析1例采用圆窗和卵圆窗加固术治疗的外伤性上半规管骨折患者的临床资料,讨论其诊断要点、治疗方法及疗效。结果患者头部外伤后出现低频声诱发眩晕、耳闷、自声增强、不能忍受低频振动等前庭功能障碍症状及听力减退;颞骨高分辨率CT示左侧上半规管顶壁多发性骨折,右侧上半规管壁单发骨折;诊断为上半规管骨折。在局麻下,耳内切口探查鼓室,用腹壁脂肪填塞圆窗,颞肌筋膜覆盖圆窗脂肪及镫骨底板周围,纤维蛋白组织胶密封颞肌筋膜与鼓室粘膜连接处;用钛质部分听骨链移植假体重建听骨链。术后患者立即体会到头部向上冲的感觉,声音诱发眩晕、耳闷、自声增强、耳鸣症状消失;左侧头部知觉恢复正常,右侧头部知觉部分恢复,听力提高,视觉定位好,视物清晰。术后14天左侧4kHz骨导听阈恢复20dB,但全频气骨导差较术前增大。结论微创的圆窗和卵圆窗加固术对撞击伤导致的上半规管裂综合症治疗效果明显。
关键词
半规管裂;眩晕;圆窗;卵圆窗;手术
基金项目(Foundation):
卫生部行业基金(201202005)资助
作者
邹静;郑宏良;高颖娜;彭日顺子;郑贵亮;
参考文献

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