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ID:21347352
大小:1.96 MB
页数:31页
时间:2018-10-21
《of_temporal bone 耳鼻咽喉科学课件》由会员上传分享,免费在线阅读,更多相关内容在教育资源-天天文库。
1、FractureoftemporalboneChunfuDaiM.D&Ph.DOtolaryngologyDepartmentFudanUniversityClassificationsLongitudinalfracturesTransversefracturesMixedfracturesLongitudinalfractures80%ofTemporalBoneFracturesLateralForcesalongthepetrosquamoussutureline15-20%FacialNerveinvolvement
2、EAClacerationTransversefractures20%ofTemporalBoneFracturesForcesintheAntero-PosteriordirectionInnerearinjury50%FacialNerveInvolvementEACintactPhysicalExaminationTuningForkexamPneumaticOtoscopyImagingHRCTMRIAngiography/MRAsymptomsHearingLoss&tinnitusDizzinessCSFOtorr
3、heaandRhinorrheaFacialNerveInjuriesHearinglossFormalAudiometryvs.TuningFork71%ofpatientswithTemporalBoneTraumahavehearinglossTMPerforationsCHL>40dbsuspicionforossiculardiscontinuityHearinglossLongitudinalFracturesConductiveormixedhearingloss80%ofCHLresolvespontaneou
4、slyTransverseFracturesSensorineuralhearinglossLesslikelytoimproveDizzinessOticcapsulefracture,labyrinthineconcussion,PerilymphaticFistulaPerilymphaticFistulasFluctuatingdizzinessand/orhearinglossTulio’sPhenomenonManagement40%spontaneouslycloseSurgicalmanagementDizzi
5、nessBPPVAcute,latent,andfatigablevertigoCanoccuranytimefollowinginjuryDixHallpikeEpleyManeuverCSFOtorrheaandRhinorrheaTemporalboneFracturesarethemostcommoncauseofCSFOtorrheaBeta-2-transferrinHRCTCSFOtorrheaandRhinorrheaManagementConservativetherapyLieinbedwithHeadel
6、evated30-45°AntibioticsSurgeryCSFOtorrheaandRhinorrheaSurgicalManagementSurgicalapproachStatusofhearingMeningocele/encephaloceleFistulalocationTransmastoidMiddleCranialFossaFacialNerveInjuriesEvaluationPreviousstatusTimeOnsetandprogressionCompletevs.IncompleteHouseB
7、rackmangradingsystemINormalNormalfacialfunctionIIMildSlightsynkinesis/weaknessIIIModerateCompleteeyeclosure,noticeablesynkinesis,slightforeheadmovementIVModeratelySevereIncompleteeyeclosure,symmetryatrest,noforeheadmovementVSevereAssymetryatrest,barelynoticeablemoti
8、onVITotalNomovementElectrophysiologicTestingNETMSTENoGNerveExcitabilityTestMaximalStimulationTest>3.5mAdifferencesuggestsapoorprognosisfo
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