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先天性镫骨足板痿管致化脓性脑膜炎反复发作较少见。我院收治1例因拟诊耳源性脑脊液漏行手术探查,证实为先天性镫骨足板瘘管及内耳畸形。患儿女,6岁,1987年1月28日入院。近15月来反复7次发作化脓性脑膜炎,偶有脑膜炎发作前右耳疼痛史。入院前2个月,曾在外院行右乳突探查术,见乳突腔内大量脑脊液涌出,无法觅找瘘口所在,故中止手术,创面愈合后转来我院。既往无双耳流脓史,个人史、家族史无异常。体检:神智、发育良好,四肢活动正常。心电图,血、尿常规,胸透均正常。乳突摄片示右气化型乳突,有乳突手术后骨缺损,乳突气房云白,示有积液和炎症。CT示上半规管顶部岩骨嵴裂开,其外侧鼓窦盖骨质稀疏变薄,可能与脑脊液耳漏有关。脑干电位:80dBV波不显示,提示右耳感音神经性耳聋,并有复聪现象。眼震电图:右前庭功能丧失可能(因配合差难以肯定)。手术方法:1987年2月11日在全麻下经耳后切口,磨除乳突皮质及其内气房,行镫骨切除及迷路切除术。术中见鼓膜和槌、砧骨无畸形,唯鼓膜色
Congenital stapedix pedicled fistula caused purulent meningitis recurrent less common. One case admitted to our hospital because of the proposed diagnosis of auricular cerebrospinal fluid leakage surgery, confirmed as congenital stapedix fistula and the inner ear deformity. Children with children, 6 years old, January 28, 1987 admission. Repeated seven episodes of purulent meningitis in the past 15 months, occasional meningitis episodes of right ear pain history. 2 months prior to admission, the right mastoid exploration was performed outside the hospital, see a large number of cerebrospinal fluid in the mastoid cavity, can not find the fistula, so the surgery was stopped, the wound was transferred to our hospital. Past without ear pus history, personal history, family history without exception. Physical examination: Sage, well-developed, normal limbs. Electrocardiogram, blood, urine, chest X-ray are normal. Mastoid radiograph shows the right gasification mastoid, mastoid bone defects after surgery, mastoid gas room cloud, showing fluid and inflammation. CT showed the semicircular canal at the top of the rockbone crest rupture, thinning of the outer side of the sinus cover bone thinning, may be related to cerebrospinal fluid otorrhea. Brainstem potential: 80dBV wave is not displayed, suggesting that the right ear sensorineural deafness, and Fucong phenomenon. Nystagmus: loss of right vestibular function may be (difficult to confirm due to poor cooperation). Surgical methods: February 11, 1987 under general anesthesia after ear ear incision, removal of the mastoid cortex and its air chamber, line tarsus resection and labyngectomy. Surgery, see the tympanic membrane and mallet, no incus incarceration, only the tympanic membrane color