Leong Samuel C, Banhegyi Gyorgy, Panarese Alessandro
Department of Otorhinolaryngology-Head and Neck Surgery, Royal Liverpool University and Broadgreen Hospitals National Health Service Trust, Liverpool, United Kingdom.
Ann Otol Rhinol Laryngol. 2012 Aug;121(8):516-20. doi: 10.1177/000348941212100804.
Complications during aural impression-taking for hearing aids are relatively rare. We present a case to highlight the need for vigilance when taking an aural impression and review the literature to identify other cases in order to assess the range of complications encountered and the sequelae of this potentially serious problem.
We present a case report and a review of the literature.
The most common complication was the entry of mold material into the middle ear cavity. This frequently occurred in patients with a preexisting perforation of the tympanic membrane, although traumatic perforation occurred in 5 cases. Spread of the mold material within the middle ear cavity was frequently extensive, with 46% of cases involving the eustachian tube. There were 6 cases of ossicular chain involvement: encasement of the ossicles in 5 and extensive ossicular erosion in 1. The extent of the surgical procedures performed varied widely, ranging from simple removal of the foreign body in the mastoid cavity to tympanomastoidectomy with a facial recess approach and ossiculoplasty. In 50% of cases, the patient recovered without any complication. However, further hearing loss was observed in 36% of cases.
When mold material is impacted in the ear canal and visualization of the middle ear is obscured, we advise against simple piecemeal removal. Such cases are best managed by an experienced otologist.
取助听器耳印模时的并发症相对少见。我们报告一例病例以强调取耳印模时保持警惕的必要性,并回顾文献以确定其他病例,从而评估所遇到的并发症范围以及这个潜在严重问题的后遗症。
我们报告一例病例并进行文献回顾。
最常见的并发症是印模材料进入中耳腔。这在鼓膜已有穿孔的患者中经常发生,不过有5例发生了外伤性穿孔。印模材料在中耳腔内的扩散通常很广泛,46%的病例累及咽鼓管。有6例听骨链受累:5例听骨被包裹,1例听骨广泛侵蚀。所进行的手术范围差异很大,从单纯清除乳突腔内的异物到采用面神经隐窝入路的鼓室乳突切除术和听骨成形术。50%的病例患者恢复且无任何并发症。然而,36%的病例出现了进一步的听力损失。
当印模材料嵌塞在耳道内且中耳视野不清时,我们不建议简单地逐块取出。此类病例最好由经验丰富的耳科医生处理。