course 3 - trauamt urechii

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  • 8/12/2019 Course 3 - Trauamt Urechii

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    MIDDLE EAR TRAUMATISMS

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    CLASSIFICATION

    1.DIRECTLY TRAUMATISM S

    THE TYMPANIC MEMBRANE TRAUMATISMS BYFOREIGNS BODY TYMPANIC MEMBRENE BURNS PRESIONAL TRAUMATISMS- BLAST, BARO TRAUMAS,BANG SUPERSONIC

    ACOUSTIC ACUTE TRAUMA ELECTRICALY TRAUMATISMS2. INDIRECTLY TRAUMATISMS

    ASSOCIATED TRAUMA LABIRINTHI FRACTURE EXTRALABIRINTH FRACTURE

    3. OSSICULAR BONES INJURIESLABYRINTHINE CONCUSSION

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    TYMPANIC TRAUMATISMS PRODUCED BY FOREIGNE

    BODY

    Symptomatology: pain, subepithelial hemorrageTM perforation with osicular chain dislocation, vestibular(vertiginous) phenomenaENT Examination: perforation in the centre of the MTTreatment: suction, dry endaural dressing in the

    external auditory canal

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    TYMPANIC MEMBRANE BURNS

    Symptomatology:Intensive pain EAC with (pete marmorate) marble trourought spots

    TM hypermia, and hiperemic, turgid large TM perforation situated in anthero-inferior partof the MT

    Treatment:Endaural dressing Antibiotic treatmentMYRINGOPLASTY after 6 month after one

    suppuration

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    BARO TRAUMATISMS

    It is produced by a pressure increasing of surroundingenvironment ,after one applying one box on the ear.

    Valsalva maneuver is difficult to performedSymptomatology:The tympanical congestionin the eptimpanic regionDifuze congestionwith a retraction of the MTHemothympan

    Linear breack of the MT Affects the Ossicular chain functionality

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    BARO TRAUMAS

    Hearing loss by unilateral compression Hearing loss by bilateral decompression- is progressivelyinstalled ,horinzontal curve

    BARO TRAUMATISMS FROM AVIATION

    Classification : Acute: ear pain, tinnitus, vertigoSubacute: transient and vague ear painChronic : low frequency transmission hearing loss- after itis turns into mixed hearing loss, and large perforationENT Examination : thickened and retracted Tympanicmembrane, hammer leveling, unilateral pain, vertigo,tinnitus, and large perforationTreatment: cleaning the EAC, after that Myringoplasty

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    BLAST

    Movement of air mass by explosion and deflagrationIt produced degenerative lesions to the labyrinth by internal earhemorrage and concussion

    SUPERSONIC BANGIt is produced by 130-145 dB sonic energy, that has a short timeactionIn this situation are produced hydrodynamical changes due to afragile cochleaSymptomatology: plugged ear , hearing loss with associate

    vertigo, degenerative labyrinth Lesions(injuries) , neural sensory

    hearing loss to high frequency

    Treatment: Vasodilatators drugs

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    ACOUSTIC ACUTE TRAUMA

    - Appears trough exposer to loud noise over a 2 hours-7days period of time

    - Perception hearing loss by high frequency with a noch

    by 400 Hz.- Nervous exhaustion Phenomenon- Treatment: vasodylatatory and vitamins drugs

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    ELECTRICAL TRAUMATISMS

    It is produced by electrocutionIs produced:

    - Directly primary lesions of TM

    - Late secondary lesions

    Perception or mixed hearing lossTympanic membrane perforations

    Associated phenomena: bone necrosis, psichiatricdisorders, cerebral atrophy, affecting language, facialparalysis, ocular complications

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    INDIRECTLY MIDDLE EAR TRAUMATISM S

    ASSOCIATED TRAUMAS- Mastoidean traumas

    - Temporo-parietaly

    - occipital- occipito-parietalLongitudinal fractures - tympanic membrane and tympanic

    cavity with intact maintaining of facial nerve

    Transverse fracture -way, vestibule, cochlea ,inferior wall ofTympanic cavity, N. facial without affecting thetympanic membrane

    Oblique fractures

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    LABYRINTH AND EXTRALABYRINTH FRACTURES

    Fracture Labyrinth: Bony labyrinth fracture. The bonylabyrinth, fracture of temporaly bone , and labyrinthineconcussionFracture Extralabyrinth : fracture of tymoanic cavity , tip

    rock, mastoidean cells and EAC Symptoms:- Perforation of tympanic Membrane- othoragy- licvoree- hearing loss to Deafness- Balance disorder

    Paralysis N. V, VI, VIITreatment: conservative or surgical- mixed surgical teams

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    POST TRAUMATICALY LESIONS OF THE

    TYMPANO-OSSICULAR SYSTEM

    Symptomatology:Transmission hearing loss, that will transforme in mixed andneural or perceptionTinnitus Balance disorders

    Localisation: Incudo-stapedian joint , long incus apophyses,stedo- vestibular joint

    Clinical Diagnosis :Tympanometrie with stapedian reflexTonal AudiometryOpening the tympanic cavity to make the diagnostic

    Treatament:Surgical-ossicular bones

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    LABYRINTH CONCUSSION

    It is a clinical manifestatio in the absence of a fractureDefinition : i rreversible damage to neurosensorial elements-

    oval window and the first round of turns of the cochlea Symptomatology :

    Hearing lossTinnitusNevralgic ear painPerception Hearing loss degenerative type by highfrequency and after that by low frequency

    Treatment: it is necessary to make stimulator implantstransistors