Download - 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