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耳异物

Aural foreign bodies.

作者信息

Mishra A, Shukla G K, Bhatia N

机构信息

Department of Otorhinolaryngology, KG Medical College, Lucknow.

出版信息

Indian J Pediatr. 2000 Apr;67(4):267-9. doi: 10.1007/BF02758167.

Abstract

At KGMC Lucknow, 168 pediatric cases with aural foreign bodies (FB) were reviewed. Most of the FB were self-inflicted and seen in children under 5 years of age (69.64%), within 24 hours (91.66%) of impaction. 86.30% of FB were seen to impact in external auditory canal (EAC) and their nature revealed predominance of nonvegetative inanimate FBs (43.45%). The TM perforation was encountered in only 6.54% of cases. If the FB is a living insect, it should be drowned before being manipulated. Syringing is the method of choice for a nonimpacted relatively small FB, even if it is vegetative. It is to be avoided in the 'potential' cases of external otitis or in cases with severely impacted wax. For a tightly wedged smooth rounded FB the hook and forceps are preferred in superficially and deep lying FBs respectively. A dissociate anaesthesia (ketamine) appears to be a better choice than general anaesthesia. An end-aural incision should be preferred over post-aural one and canalplasty for access of FB should be carried out wherever necessary. The presence of otorrhoea in cases of penetrating FB or aural myasis should be dealt on the lines of otitis media after removing the FB concerned.

摘要

在勒克瑙国王乔治医学院,对168例小儿耳异物(FB)病例进行了回顾。大多数异物是儿童自行塞入的,多见于5岁以下儿童(69.64%),异物塞入后24小时内就诊的占91.66%。86.30%的异物位于外耳道(EAC),其性质显示非植物性无生命异物占多数(43.45%)。仅6.54%的病例出现鼓膜穿孔。如果异物是活昆虫,在处理前应将其淹死。对于未嵌顿的相对较小的异物,即使是植物性的,冲洗也是首选方法。在“潜在”外耳道炎病例或蜡样物严重嵌顿的病例中应避免冲洗。对于紧密楔入的光滑圆形异物,分别在浅表和深部嵌顿的异物中,钩和镊子是首选工具。分离麻醉(氯胺酮)似乎比全身麻醉更好。应首选耳内切口而非耳后切口,必要时应进行外耳道成形术以取出异物。对于穿透性异物或耳蛆病病例,在取出相关异物后,应按照中耳炎的处理原则处理耳漏问题。

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