11例迷路震荡的法医临床学鉴定分析

目的 探讨迷路震荡的法医临床学鉴定的有关问题。方法 对11例15耳迷路震荡的法医临床学鉴定资料进行回顾性研究。结果 11例迷路震荡伤者,均有头部受伤史,伤后短时间内出现耳鸣、听力下降,其中4例伴前庭症状;常规耳科检查和头颅及颞骨CT扫描无异常;各种听力学检查提示感音神经性聋或混合性聋;选择ABR和/或40Hz AERP检测客观听阂,11例有不同程度听力损失,以高频听力损失为主,其中双耳4例,单耳7例;鉴定时间在伤后2-8个月;鉴定为轻伤6例,重伤5例。结论 头部外伤后短时间内出现耳鸣、听力下降,可伴前庭症状,常规耳科检查和头颅及颞骨CT扫描无异常,以及各种听力学检查提示感音神经性聋或混合性聋,可诊断迷路震荡,损伤程度鉴定至少在伤后2-3个月进行。

Analysis on clinical forensic medical expertise in 11 cases of labyrinthine concussion

Objective To explore some problems of clinical forensic medical expertise on labyrinthine concussion. Methods The data of 15 ears in 11 cases of forensic medical expertise of labyrinthine concussion had been retrospectively studied. Results All the 11 cases of labyrinthine concussion suffered from head injury. The symptoms of tinnitus and audio descent had been presented in short time after head injury , 4 cases among them accompanied with vestibular symptoms. The routine otological examination had no special finding, head and temporal bone CT scanning indicated normality. All kinds of auditory checks indicated sensorineural deafness or mixed deafness. ABR and / or 40Hz AERP were the objective methods of detecting auditory threshold. 15 ears among 11 cases had different hearing loss, mainly high frequency hearing loss; There were only 4 cases of both ears injury, but 7 cases were single ear injury. The expertise time were 2 -8 months; The middle injury were 6 cases, and the severe injury were 5 cases. Conclusion The main expertise points of labyrinthine concussion caused by head injury are as follows: The symptoms of tinnitus and audile descent appeared in short time after head injury, and vestibular symptoms can be accompanied ; the routine otological examination has no special finding, the head and temporal bone CT scan are normal; all kinds of auditory checks indicate sensorineural deafness or mixed deafness; ABR and/or 40Hz AERP can be selected as the objective methods for detecting auditory threshold. The expertise time should be with in 2 - 3 months at least.