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患者,男,36岁。因颏部外伤后双耳道流血、听力减退2小时,于1993年9月6日来我院就诊。2小时前患者因酒后骑自行车不慎摔倒,颏部着地后该处皮肤裂伤、出血伴双耳闷塞感,听力下降,流少量鲜血,伤后无意识丧失及恶心、呕吐。检查:一般情况好,神志清,双瞳孔等大等圆,光反射存在。颏部正中见约2.5cm的横行皮肤裂伤,深及皮下,张口轻度受限,咬合关系良好。双外耳道口见少许血迹,无清水样液体外溢,耳屏前轻度压痛,外耳道狭窄,前壁后移与后壁接触,鼓膜窥不见。音叉试验示;双耳传导性聋。诊断为:①颏部皮肤裂伤;②双外耳道前壁骨折;③传导性聋(双)。局麻下先清创缝合颏部伤口,然后行外耳道前壁复位术,方法如下:病人坐位,嘱其张口,取鼻中隔矫正所用的薄长鼻镜轻轻插入
Patient, male, 36 years old. Due to chin injury after ear canal bleeding, hearing loss 2 hours, in September 6, 1993 to our hospital. Two hours ago, the patient fell accidentally due to drunken driving. After the chin had landed on the skin, there was laceration of the skin, bleed with binaural feeling, hearing loss, a small amount of blood flow, unconscious loss after injury and nausea and vomiting. Check: the general situation is good, clear mind, double pupil and other round, light reflection exists. In the middle of the chin, see transverse cleft lace of about 2.5cm, deep and subcutaneously, with limited mouth opening and good occlusion. Double external auditory canal see a little blood, no water-like liquid spills, mild tenderness before the tragus, external auditory canal narrowing, anterior wall posterior shift and posterior wall contact, eardrum glimpse. Tuning fork test shows; binaural deafness. Diagnosis: ① chin skin laceration; ② double external ear canal anterior wall fracture; ③ conductive deafness (double). Local anesthesia first debridement chin suture wound, and then the external auditory canal anterior wall reduction, the method is as follows: the patient sitting position, instruct the mouth, take nasal septum thin long nose mirror used to gently insert