auditory ossicle trauma
Introduction
Introduction to small bone trauma Direct or indirect trauma causes conductive hearing loss to exceed 50 dB from the beginning or 6 weeks after injury, and there are still conductive deafness with a bone conduction difference greater than 40 dB. The possibility of ossicular dislocation or fracture should also be considered. Paying attention to production safety and avoiding trauma is the key to the prevention and treatment of this disease. At the same time, attention should be paid to the active treatment of primary diseases such as otitis media, which can cause ossicular damage, and early detection and early treatment are more conducive to prevent the occurrence of this disease. basic knowledge The proportion of sickness: 0.01% Susceptible people: no specific population Mode of infection: non-infectious Complications: craniocerebral injury deafness
Cause
Listening to the cause of small bone trauma
1, skull trauma
It is the main reason for the dislocation and fracture of the small bone. About 24% to 30% of the head trauma and various structures contained in the tibia, which easily cause dislocation of the anvil joint (accounting for 75% of the trauma of the small bone); Bone fractures, foot plate displacement and anvil separation are less common (accounting for 25% of small bone trauma), and occasionally bilateral lesions can be produced.
2. Direct damage to the small bone
1 accidental tympanic membrane perforation and ossicular injury when taking foreign bodies or sputum in the external auditory canal;
2 for the secretion of otitis media when the position of the snorkel is too biased, can cause dislocation of the incision; the vent tube directly compresses the anvil bone prominence, which can cause necrosis of the incision;
3 posterior tympanic incision technique can lead to accidental dislocation of the anvil;
4 During mastoid surgery, the probe is used to explore the entrance of the sinus sinus, causing dislocation of the incision.
Prevention
Listening to small bone wound prevention
Pay attention to the safety of production and life, and avoid trauma is the key to the prevention and treatment of this disease. At the same time, it should also pay attention to actively treating primary diseases, such as otitis media, which can cause small bone injury. Early detection, early diagnosis and early treatment are more conducive to preventing this disease. The occurrence of the disease.
Complication
Listening for small bone trauma complications Complications, brain injury, deafness
The small bone trauma is complicated by other parts of the injury, mainly the brain injury, and the complications caused by the small bone disease are rare, mainly the following:
1. In the case of ossicular fracture combined with the upper wall fracture after the external auditory canal, the ossicular bone and the osseous drum ring can be formed and fixed, and may fall again during the hearing recovery process.
2. As for those who have lost contusion or concussion, there are fewer chances for recovery of sensorineural deafness.
Symptom
Auditory symptoms of small bone trauma Common symptoms Hearing defects Conductive deafness, earache, ear vestibular hearing imbalance
After tympanic membrane and ossicular injury, conductive deafness may occur, accompanied by hearing loss caused by inner ear injury. In the case of conductive deafness, the general prognosis is good, and most of them have the possibility of recovery, but if the conductive deafness starts more than 50dB, It should be highly suspected that there is a dislocation of the ossicle or a fracture of the ossicular bone. It is very unlikely that the hearing will naturally return to normal. In addition, if there is still a conductive deafness with a bone conduction difference of >40 dB 6 weeks after the injury, the ossicular bone should also be considered. Dislocation or fracture possibility, traumatic conductive hearing loss is mainly caused by tympanic blood, tympanic membrane rupture, ossicular chain dislocation or fracture, etc., tympanic blood accumulation more than 3 weeks self-absorption or discharge through the eustachian tube, hearing Can be gradually improved, the upper tympanic blood or vestibular wear and vaginal perforation residual hematoma and middle ear mucosal edema reaction, hearing recovery may be late.
Examine
Listening for small bone trauma
The examination of the small bones is mainly performed by ultrasound:
(1) Listening to the normal sound image of the small bone: listening to the small bone like a "C" type strong echo, the head end strong echo small light group is the hammer bone, the boundary is not smooth, the neck is the hammer anvil joint echo, the vertical part is the anvil bone The edge is rough and strong echo, the bottom end is the echo of the humerus, the anechoic dark area in the vertical part is the hammer bone decay area, the eustachian tube is visible on the upper part corresponding to the small bone, and the curved tube is in the anechoic dark area. The echo moves forward.
(2) Acoustic bone destruction sound image: "C" type strong echo shape disappears, visible slightly thick and strong echoes, uneven unequal echoes in the middle, echoes at both ends are enhanced, and the acoustic image of the small bones is destroyed. The degree of damage to the small bones is closely related. The severe ones listen to the strong echoes of small soybeans with uneven size of soybeans.
Diagnosis
Diagnosis of small bone trauma diagnosis
The disease can be diagnosed according to clinical and examination, no need to identify, but it is more important in clinical practice to differentially diagnose the cause of ossicular injury, because there are many causes of ossicular injury, such as head injury, otitis media, Or other factors directly cause damage to the small bones, etc., the correct identification and diagnosis of these causes, in order to give patients timely and correct treatment, so that patients recover as soon as possible.
