外傷性聽小骨分離

Traumatic Ossicular Chain Discontinuity

陳新鵬(Shin-Peng Chen) ； 黃俊生(Tsun-Sheng Huang)

《中華民國耳鼻喉科醫學會雜誌》 27卷4期 (1992/12) Pp. 310-313

https://doi.org/10.6286/1992.27.4.310

摘要

本研究於1983年至1991年間，在長庚醫院收集外傷性聽小骨分離者共12例，來探討其外傷的種類、手術的時間及方法，以及病人改善的程度。結果12例（男8例，女4例），平均受傷年齡為24.8歲，其中因車禍而引起的有6例，其他如游泳、撞牆、重物擊中等有5例，竹棒挖耳引起的有1例。受傷後有6例在1個月內接受手術，4在1個月至1年期間，另有2例分別在4年及14年後才接受手術。術前，12例皆有傳音性聽力障礙及耳鳴現象，經手術結果有11例是砧骨與鐙骨移位，1例是鐙骨兩肢斷裂，分別施以砧骨或軟骨間置術或PORP。術後3個月，聽力由平均47.8 dB聽損進步到23.6 dB聽損，而耳鳴症狀則有一半（6例）消失。因此對於外傷性聽小骨分離，施以手術對病人症狀的改善有很好的效果。

關鍵字

砧骨鐙骨分離 ； 砧骨間置術

並列摘要

From 1983 to 1991 at CGMH, a series of twelve consecutive patients with traumatic ossicular chain discontinuity was collected to investigate the type of trauma, the average delay from trauma to operation, the operative methods, and the hearing change after operation. Pre-operative studies included pure tone audiometry, mastoid x-ray, tympanogram, and careful history taking. Young males dominated the age-sex distribution and car accidents were main categories of trauma.
Operative findings showed separation of the incudostapedial joint in 11 cases (91.6%) and fracture of the stapedial crus in 1 case (8.4%). Tympanoplasty type Ⅱ (interposition of homograft or autograft incus or cartilage, and PORP) was used in 11 cases and tympanoplasty type Ⅲ (incus interposition) was used in one case. The post-operative hearing was evaluated by the pure tone audiometry done three months after operation, and it showed obvious improvement from 47.8 dB hearing loss pre-operatively to 23.6 dB hearing loss post-operatively. The average delay from trauma to operation had no direct relationship with the hearing improvement. Besides, the symptom of tinnitus was gone in half of the 12 cases.

並列關鍵字

incudostapedial joint separation ； incus interposition