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患者,男,28岁。1月前无明显诱因右耳痛,右耳廓及其后上方头皮出现疱疹,并流黄水,数天后右耳剧痛,同侧头痛,先后出现右耳聋、耳鸣,面瘫伴眩晕、恶心呕吐,因患者有慢性中耳炎史(已半年不流脓),当地医院急诊行乳突探查术,病历记载术中无明显异常,术后症状无减轻。本院门诊以中耳炎伴面瘫收住院,拟行面神经减压术。检查见一般情况好,右侧周围性完全性面瘫,有向左水平旋转性 I 度眼震,指鼻试验正常,闭目难立征阳性,向右倾倒;右耳甲腔皮肤有黑色结痂,耳后上方发际处有片状色素沉着,右乳突腔未干有分泌物,鼓膜尚存;电测听示右耳重度神经性聋(气导70dB)。肌电图为右面神经
Patient, male, 28 years old. 1 month ago, no obvious incentive for right ear pain, right ear and then the top of the scalp herpes appear and flow yellow water, a few days after the right ear pain, ipsilateral headache, there have been deafness, tinnitus, facial paralysis with dizziness, nausea and vomiting , Because patients have a history of chronic otitis media (no sepsis for six months), the local hospital emergency mastoidectomy, medical records no significant intraoperative abnormalities, postoperative symptoms without mitigation. Otolaryngitis clinic with paralysis admitted to hospital, proposed facial nerve decompression surgery. Check the general situation is good, the right peripheral complete facial paralysis, left horizontal rotation of I degree of nystagmus, finger nasal test normal, closed eyes hard to stand positive, right dumping; right ear shell cavity with black scab , Behind the ear hair patchy pigmentation at the top of the ear, right breast papillae have no secretions, tympanic membrane surviving; electrical audiometry showed severe deafness of the right ear (air conduction 70dB). EMG for the right side of the nerve