表现为眩晕的鼻窦炎并发化脓性中耳炎、迷路炎、脑膜炎1例并文献复习
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摘要
目的探讨一例鼻窦炎并发急性化脓性中耳炎、化脓性迷路炎、化脓性脑膜炎的发病过程,病情演变及治疗情况。方法针对该患者首发眩晕,听力下降,由鼻窦炎引发中耳炎、迷路炎、脑膜炎的演变过程进行了分析讨论。结果因为首发症状是眩晕,中耳炎,经过密切观察,病情继而演变为颅内感染的化脓性脑膜炎,经过耳鼻咽喉科、神经内科、ICU联合救治,得以痊愈。结论对于有中耳炎表现的眩晕患者,应该注意结合听力检查,眼震检查,包括密切观察病情变化,不能疏忽一切可疑的症状和体征,方可避免疾病的漏诊漏治。
Objective To investigate the pathogenesis,evolution and treatment of acute suppurative otitis media,suppurative labyrinthitis and suppurative meningitis in a case of sinusitis. Methods The course of otitis media,labyrinthitis and meningitis induced by sinusitis was analyzed and discussed. Results Because the first symptom was vertigo,otitis media,after close observation,the condition then evolved into suppurative meningitis with intracranial infection,which was cured by the joint treatment of otolaryngology,neurology and ICU. Conclusion For the vertigo patients with otitis media,attention should be paid to the combination of hearing examination and examinationof nystagmus,including close observation of the condition changes,not to neglect all suspicious symptoms and signs,in order to avoid missed diagnosis and treatment of the disease.
Objective To investigate the pathogenesis,evolution and treatment of acute suppurative otitis media,suppurative labyrinthitis and suppurative meningitis in a case of sinusitis. Methods The course of otitis media,labyrinthitis and meningitis induced by sinusitis was analyzed and discussed. Results Because the first symptom was vertigo,otitis media,after close observation,the condition then evolved into suppurative meningitis with intracranial infection,which was cured by the joint treatment of otolaryngology,neurology and ICU. Conclusion For the vertigo patients with otitis media,attention should be paid to the combination of hearing examination and examinationof nystagmus,including close observation of the condition changes,not to neglect all suspicious symptoms and signs,in order to avoid missed diagnosis and treatment of the disease.
引文
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2.张洪昌.急性中耳炎并发颈内静脉球血栓性静脉炎1例.中华耳鼻咽喉科杂志,1987,22:105.
3.张庆泉,任忠,朱宇宏,等.自体骨膜骨片修补迷路瘘管.中华耳鼻咽喉科杂志,1996,31:270.
4.张庆泉,陈秀梅,邢建平.迷路瘘管.山东大学耳鼻喉眼学报,2002,16:309-310.
5.王锡温,孙岩,张庆泉.影像导航下耳源性脑脓肿引流术.中华耳鼻咽喉头颈外科杂志,2015,50:848-850.