颞骨外伤后感音神经性耳聋的治疗:附23例报告

Oulghoul O
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摘要

摘要简介:颞骨骨折常导致听庭功能丧失。耳囊侵犯性骨折与耳囊保留性骨折相比,感音神经性听力损失的发生率更高。材料和方法:2013年1月至2017年6月在马拉喀什穆罕默德六世大学医院中心进行的前瞻性研究,涵盖23例颞骨创伤背景下的感音神经性听力损失。结果:平均年龄31岁(4 ~ 56岁),男性占明显优势(性别比21.5)。临床症状表现为听力丧失,耳出血20例,眩晕13例,面瘫10例,耳漏5例。96%的患者表现为迷路骨折。其中2例为气腹畸形,1例为双侧颞骨骨折。听力测定显示感音神经性听力损失9例,混合性听力损失14例。其中一例为双侧听力损失,一侧为重度感音神经性听力损失,另一侧为中度。结论:颞骨骨折是最常见的外伤性损伤之一,可导致听觉和前庭功能丧失。诊断必须在创伤后几个小时内作出,因为听觉预后取决于早期的处理。在受影响的一方,听觉后遗症可以达到完全听力丧失。
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Management of Sensorineural Deafness in Temporal Bone Trauma: A Report of 23 Cases
objectified Abstract Introduction: Temporal bone fractures often lead to loss of audio-vestibular function. Otic capsule violating fractures are associated with higher incidence of Sensorineural hearing loss than otic capsule sparing fractures. Material and methods: Prospective study conducted at the Mohammed VI University Hospital center of Marrakech, from January 2013 to June 2017, covering 23 cases of sensorineural hearing loss in the context of Temporal bone trauma. Results: The mean age was 31 years (4-56 years), with a clear male predominance (sex ratio 21/2). Clinical symptomatology was characterized by hearing loss in all our patients, otorrhagia in 20 cases, vertigo in 13 cases, facial paralysis in 10 cases, and otoliquorrhea in 5 cases. 96% of patients presented with labyrinthine fractures. Two cases of pneumolabyrinth and one case of bilateral temporal bone fracture were noted. The audiometry showed sensorineural hearing loss in 9 cases and mixed in 14 cases. In one case the hearing loss was bilateral with severe sensorineural hearing loss on one side and moderate on the other side. Conclusion: Temporal bone fracture is one of the most common traumatic injuries that can cause loss of auditory and vestibular function. The diagnosis must be made within a few hours after the trauma, as the auditory prognosis depends on the earliness of the management. Auditory sequelae can go as far as complete hearing loss, on the affected side.
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