颞骨骨折及其中、内耳损伤48例回顾性研究

目的　探讨颞骨骨折及中、内耳损伤的特点及救治。　方法　对 1989年 1月～ 1999年 11月收治的 48例颞骨骨折的临床资料进行回顾性分析。　结果　 (1) 4 8例颞骨骨折占同期颅-颅面骨折的 17% ,其中交通事故所致的颞骨骨折 32例 (6 7% ) ;(2 )本组合并中、内耳和 (或 )颅脑损伤 37例 (77% ) ,2 3例 (4 8% )出现听力下降或耳鸣 ;(3)纵行骨折致脑脊液耳漏 12例 (36 % )、面瘫1例 (3% ) ;横行骨折致面瘫 3例 (37% ) ,脑脊液耳漏 2例 (2 5 % ) ;(4 )早期急救手术占 96 % ,其中颅脑手术占所有急救手术的 46 % ,Ⅱ期手术占 17% ,存活 43例 (90 % ) ,死亡 5例 (10 % )。　结论　(1)交通伤是造成颞骨骨折的首要高危因素 ;(2 )骨折易并发中、内耳或颅脑损伤 ,其中听力下降或耳鸣是常见的耳并发症 ;(3)纵行骨折的脑脊液耳漏多见 ,横行骨折易造成面瘫 ;(4 )早期救治应该着重抢救生命 ,保证呼吸道通畅 ,维持循环系统功能。

A retrospective study on temporal bone fracture and medial-inner ear injury

Objective To explore the characteristics and treatment of the temporal bone fracture and the injury in the medial-inner ear. Methods The clinical data of 48 cases of the temporal bone fracture to our hospital from Jan.1989 to Nov.1999 were retrospectively analysed. Results (1)Forty-eight cases temporal bone fracture held 17% of the crania-craniofacial fracture and the temporal bone fracrture by traffic accidents held 67% of 48 cases; (2)The injury in the medial-inner ear or craniocerebrale held 77% and the hearing loss or tinnitus held 48%; (3) The cerebrospinal otorrhea and facioplegia held 37% and 3% in the longitudinal fracture, that in the transversal fracture were 25% and 37%; (4) The primary emergent operation held 96% of 48 cases and the neuro-surgery held 46% of the whole operation, the secondary procedures held 17%.43 cases survived(90%),5 cases died( 10 %). Conclusions (1) The traffic injury was the first high-dangerous factor to temproal bone fracture;(2)The medial-inner ear or craniocerebrale was easily injured under the temporal bone fracture; (3) The cerebrospinal otorrhea was common in the longitudinal fracture and the facioplegia was common in the transversal fracture; (4) The key step is rescuring the life, keeping airway unobstructed and maintenance circulation in the primary emergency treatment.