摘要
目的总结外伤性鼓膜穿孔的法医学鉴定规律。方法回顾性分析308例316耳外伤性鼓膜穿孔法医学鉴定资料。结果确诊外伤性鼓膜穿孔237耳,穿孔愈合50耳,穿孔合并感染6耳,排除穿孔11耳,8例(耳)排除与所受外伤的关系,3例(耳)无法认定外伤性鼓膜穿孔,1例(耳)诊为慢性化脓性中耳炎。结论外伤性鼓膜穿孔诊断要点为:(1)有耳部或头部受伤史;(2)伴耳痛、耳聋、外耳道少量出血;(3)形态符合外伤性穿孔特点:穿孔多位于紧张部,呈裂隙状、三角形、不规则形等,穿孔边缘锐利、外翻,附有血痂;(4)声导抗检查不能引出鼓室图,或伤耳呈B型曲线但外耳道容积明显大于健耳:(5)排除中耳炎所致穿孔。声导抗和耳内镜检查可以客观真实的反映鼓膜穿孔的形态特征,能为外伤性鼓膜穿孔的法医学鉴定提供客观依据。
Objective The purpose of this study is to evaluate the clinical features in patients with a traumatic perforation of the tympanic membrane and to discuss its forensic implications. Methods Data of 308 cases （316 ears） suggestive of a traumatic perforation of the tympanic membrane were retrospectively analyzed. Results Of all suspected patients, 237 were finlly diagnosed as traumatic tympanic membrane perforation, 50 as having healed tympanic membranes, 6 with secondary infection; 11 cases had no perforation of the ear drum, in 8 cases the data excluded a contributory role of trauma in the tympanic membrane perforation, 1 case was diagnosed as chronic suppurative otitis media and 3 case remained uncertain. Conclusion The main criteria for diagnosis of traumatic tympanic membrane perforation are as follows： （1） a history of head or ear trauma; （2） aural symptoms （otalgia,deafness or hemorrhage in the external auditory canal）;（3） slit- , spindle-, triangular-, or irregular-shaped perforations located in the parts tensa; （4） the affected ear failed tympanometry or showing type B tympanogram but with a bigger external canal volume;（5） eliminate those with chronic suppurative otitis media.
出处
《中华耳科学杂志》
CSCD
2006年第1期52-54,共3页
Chinese Journal of Otology
关键词
外伤性鼓膜穿孔
法医学鉴定
Traumatic tympanic membrane perforation
Forensic medical identification
