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小儿肺迷路:耳科创伤的处理

Pediatric pneumolabyrinth: managing otologic trauma.

作者信息

Andrade António, Silva Sousa Patrícia, Sousa José Maria, Coutinho Gil, Valente Pedro, Vaz Ricardo, Pinto Moura Carla, Marques Pedro, Spratley Jorge

机构信息

Department of Otorhinolaryngology, Unidade Local de Saúde São João, Porto, Portugal.

Unit of Otorhinolaryngology, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal.

出版信息

Eur Arch Otorhinolaryngol. 2025 May;282(5):2761-2765. doi: 10.1007/s00405-024-09196-6. Epub 2025 Feb 1.

Abstract

INTRODUCTION

Penetrating middle ear trauma-induced pneumolabyrinth is an exceedingly rare finding in pediatric patients. This condition can lead to significant hearing and vestibular dysfunction. We present two pediatric cases, highlighting their clinical complexity.

CASES PRESENTATION

Case 1 presented a 9-year-old boy with hearing loss, vertigo, and vomiting following a penetrating trauma to the left ear. Surgical exploration revealed ossicular chain disruption and perilymphatic fistula, which were repaired. Despite initial recovery, he developed ossifying labyrinthitis and required cochlear implantation. Case 2 described a 15-year-old boy who had right-sided hearing loss and vertigo after right ear trauma. Conservative management resulted in improvement of vestibular symptoms, but the profound hearing loss remained. The family declined cochlear implantation, due to the patient's athletic activities.

CONCLUSIONS

Penetrating trauma-induced pneumolabyrinth in pediatric patients is extremely rare. These cases demonstrate the importance of tailored treatment approaches and vigilant follow-up to optimize auditory and vestibular outcomes.

摘要

引言

穿透性中耳外伤导致的气迷路在儿科患者中极为罕见。这种情况可导致严重的听力和前庭功能障碍。我们介绍两例儿科病例,突出其临床复杂性。

病例展示

病例1是一名9岁男孩,左耳穿透性外伤后出现听力损失、眩晕和呕吐。手术探查发现听骨链中断和外淋巴瘘,并进行了修复。尽管最初有所恢复,但他发展为骨化性迷路炎,需要进行人工耳蜗植入。病例2是一名15岁男孩,右耳外伤后出现右侧听力损失和眩晕。保守治疗使前庭症状有所改善,但严重的听力损失仍然存在。由于患者的体育活动,其家属拒绝了人工耳蜗植入。

结论

儿科患者中穿透性外伤导致的气迷路极为罕见。这些病例表明了采用个性化治疗方法和进行密切随访以优化听觉和前庭结果的重要性。

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