Jahrsdoerfer R A, Johns M E, Cantrell R W
Laryngoscope. 1978 Oct;88(10):1589-95. doi: 10.1288/00005537-197810000-00004.
Surgical trauma inflicted upon the membranous labyrinth is an uncommon, but often catastrophic, complication of chronic ear surgery. Areas most vulnerable to injury are the oval window and the lateral semicircular canal. Methods of injury include subluxation of the footplate, fracture of the lateral canal by drill or chisel, and accidental opening of a fistula. Three cases of labyrinthotomy of the lateral canal during ear surgery are presented. Two occurred while drilling, and the other was associated with a dehiscence of the bony and membranous labyrinth from a cholesteatoma. The cases are documented by pre and postoperative audiograms, vestibular function tests, and photographs. Of interest is the fact that in none of these cases was cochlear function compromised. In one case the hearing actually improved. The dictum that an accidentally opened labyrinth will automatically result in a dead ear is shown to be not necessarily true. Possible explanations for this phenomenon are discussed.
中耳手术对膜迷路造成的创伤是一种罕见但通常具有灾难性的慢性耳科手术并发症。最易受伤的部位是卵圆窗和外半规管。损伤方式包括镫骨足板半脱位、用钻头或凿子导致外半规管骨折以及意外造成瘘管开放。本文介绍了3例耳科手术中外半规管迷路切开术的病例。2例发生在钻孔时，另1例与胆脂瘤导致的骨迷路和膜迷路裂开有关。通过术前和术后听力图、前庭功能测试及照片记录这些病例。有趣的是，这些病例中无一例耳蜗功能受损。其中1例听力实际上还得到了改善。那种认为意外开放的迷路会自动导致患耳失聪的说法被证明不一定正确。文中讨论了对此现象的可能解释。
