Ogren F P, Edmunds A L
Department of Otolaryngology-Head and Neck Surgery, University of Nebraska Medical Center, Omaha 68198-1225, USA.
Semin Neurol. 1995 Sep;15(3):256-62. doi: 10.1055/s-2008-1041030.
Although lightning injuries are common, neuro-otologic sequelae are infrequently reported. The most common otologic injury encountered in the lightning strike victim is tympanic membrane rupture; the most common vestibular disturbance documented is transient vertigo. A variety of other clinical findings have been described in this population of patients. They include sensorineural hearing loss, conductive deafness, tinnitus, basilar skull fracture, avulsion of the mastoid bone, burns to the external auditory canal, and peripheral facial nerve palsy. The initial treatment of the lightning strike victim consists of basic life support measures. Once stabilized, the patient should undergo a complete otologic and vestibular evaluation. The majority of otolaryngologic problems encountered can be managed expectantly, with periodic re-evaluation. Tympanoplasty should be delayed for 6 to 12 months because of the frequent delay in spontaneous healing.
虽然雷击伤很常见，但神经耳科后遗症的报道却很少。雷击受害者最常见的耳科损伤是鼓膜破裂；记录到的最常见的前庭功能障碍是短暂性眩晕。在这类患者中还描述了多种其他临床发现。它们包括感音神经性听力损失、传导性耳聋、耳鸣、颅底骨折、乳突骨撕脱、外耳道烧伤以及周围性面神经麻痹。雷击受害者的初始治疗包括基本生命支持措施。病情一旦稳定，患者应接受全面的耳科和前庭评估。遇到的大多数耳鼻喉科问题可进行观察处理，并定期重新评估。由于鼓膜破裂后自发愈合常常延迟，鼓室成形术应推迟6至12个月。
