Hagan W E, Tabb H G, Cox R H, Travis L W
Laryngoscope. 1979 Aug;89(8):1258-72. doi: 10.1002/lary.1979.89.8.1258.
By retrospective analysis of 35 surviving gunshot injuries to the temporal bone and by presentation of 6 representative cases, the management and reconstructive procedures of these injuries in the Tulane University affiliated hospitals are presented. The most frequent single injury was facial nerve paralysis (16 cases), followed by external canal injury and conductive hearing loss. Anacusis occurred in 12 cases. In conductive hearing loss the intact posterior wall tympanoplasty with mastoidectomy (16 cases), or the modified radical mastoidectomy (5 cases), allowed middle ear reconstruction. Transmastoid facial canal decompression, combined with the above procedures or with a middle fossa craniotomy, was performed in 6 cases. Delayed facial reconstruction (5 cases) utilized microneural anastomosis between facial-facial and hypoglossal-facial nerves and fascia lata slings. Intracranial complications of thrombosis of internal carotid artery, dural venous lacerations, temporal lobe aphasia, bitemporal hemianopsia, cerebral abscesses and meningitis are also discussed.
通过对35例颞骨枪伤幸存者的回顾性分析，并展示6例具有代表性的病例，介绍了杜兰大学附属医院对这些损伤的处理和重建手术。最常见的单一损伤是面神经麻痹（16例），其次是外耳道损伤和传导性听力损失。12例出现全聋。对于传导性听力损失，采用完整后壁鼓室成形术加乳突切除术（16例）或改良乳突根治术（5例）进行中耳重建。6例行经乳突面神经管减压术，可联合上述手术或中颅窝开颅术。延迟面神经重建（5例）采用面神经-面神经和舌下神经-面神经微神经吻合术以及阔筋膜吊带。还讨论了颅内并发症，包括颈内动脉血栓形成、硬脑膜静脉撕裂、颞叶失语、双颞侧偏盲、脑脓肿和脑膜炎。
