Service d'Oto-Rhino-Laryngologie et Chirurgie de la Face et du Cou, Assistance Publique-Hôpitaux de Marseille, CHU Nord, chemin des Bourrely, 13915 Marseille cedex 20, France.
Eur Ann Otorhinolaryngol Head Neck Dis. 2013 Nov;130(5):283-7. doi: 10.1016/j.anorl.2012.04.012. Epub 2013 Jun 10.
Temporal bone fracture is a common complication of high-energy cranial trauma. Labyrinth involvement is rare, but there is a risk of perilymphatic rupture that is often underestimated on initial clinical examination due to the predominance of neurological and/or somatic symptoms.
A patient presented with overlooked perilymphatic fistula, decompensated by hyperpressure effort due to poorly adapted management.
Following a review of the literature on post-traumatic pneumolabyrinth, overall management (from diagnosis to treatment, via prevention advice) was analyzed. A constructive critique of the patient's treatment was thus made.
We argue for a systematic management protocol in cranial trauma with temporal bone fracture, comprising ENT examination, millimetric-scale cross-sectional imaging of the fracture site, and standardized counseling to prevent late complications.
颞骨骨折是高能颅脑创伤的常见并发症。迷路受累较为罕见,但由于最初临床检查中神经和/或躯体症状占主导地位,常常低估了外淋巴瘘的风险。
一位患者出现了被忽视的外淋巴瘘,由于管理不当导致高压努力代偿失调。
对创伤性气压迷路后的文献进行回顾后,分析了整体管理(从诊断到治疗,再到预防建议)。对患者的治疗进行了建设性的批评。
我们主张对颞骨骨折的颅脑创伤患者进行系统的管理方案,包括耳鼻喉科检查、骨折部位的毫米级横断面成像以及标准化咨询以预防晚期并发症。