耳爆炸傷—病例報告

Ear Blast Injury-A Case Report

洪士涵(Shih-Han Hung) ； 徐愫儀(Su-Yi Hsu) ； 王拔群(Pa-Chun Wang)

《慈濟醫學雜誌》 16卷3期 (2004/06) Pp. 205-210

https://doi.org/10.6440/TZUCMJ.200406.0205

摘要

聽覺系統是在爆炸中最容易受傷的器官，但急診醫護人員在處理緊急重大傷害時，往往容易忽略了聽覺器官傷害的可能性。我們在此報告一位於2002年10月峇里島爆炸事件中倖存的白種男性。病人的主訴為輕微頭昏及兩側聽力障礙，左右耳分別達到35及32分貝。於手術當中我們發現左耳鼓膜破裂達75%，併有腦脊髓液外漏，以及砧骨、鐙骨分離，此解釋了病人為何有頭暈以及雙耳傳導性聽力障礙之現象。病人中耳經適當的中耳重建手術之後，鼓膜癒合良好，傳導性聽力障礙消失。耳爆裂傷在文獻上很少報告，本文討論耳爆裂傷之機轉，並以病理生理學發現、處理方式以及結果，特此提出報告。

關鍵字

耳爆炸傷 ； 傳導性聽力障礙 ； 腦脊髓液外漏

並列摘要

The auditory apparatus is the most vulnerable organ system to a blast injury, but blast damage to the auditory system is often overlooked in the emergency room when management of other life-threatening major vital organ trauma is prioritized. We report on a Caucasian patient who survived the Bali Island bombing in October 2002. The patient presented with dizziness, otorrhea, conductive hearing loss, and bilateral tympanic membrane perforation. CSF leakage and incus-stapes joint dislocation were found in the left ear during the operation. Spontaneous healing of the right tympanic membrane perforation was noted 3 months after the blast injury. His conductive hearing loss returned to normal, and the CSF leakage ceased after proper middle ear reconstruction. Ear blast injury is rarely reported in peacetime literature; we discuss the mechanism, pathophysiology, management, and outcomes of this unusual situation.

並列關鍵字

ear blast injury ； conductive hearing loss ； CSF leakage