患者为女性,12岁,主诉眩晕,左耳聋,耳鸣,既往身体健康,无耳部疾病.于1981年7月13日在院内玩耍时,突然从上方掉下一树枝刺入左外耳道.当时自觉疼痛剧烈,自此以后,出现波动性“工”声及持续性“金”声,左耳鸣,左耳听力下降,并有旋转性眩晕及呕吐.经卧床休息,症状无改善,当日即就诊.初诊检查:耳廓,外耳道无病变,左鼓膜充血明显,紧张部后上象限穿孔,通过穿孔,见砧骨前方移位.砧骨脱离,位于被血块埋没的镫骨头的前方.注视眼震未见明显眼震,向上面看时,可见向右水平自发性眼震,无面神经麻痹.由于上述情况、怀疑为外伤性鼓膜穿孔,合并听骨链脱离,以及外淋巴瘘,而当日急症入院.次日(14日)行纯音听力检查,呈混合性耳聋.平衡机能检查,Romberg氏征为阴性,Mann检查,单足站立向左倾倒,不能作踏步检查,无小脑及瘘管征象,注视眼震,未见明显眼震,头位性眼震,可见垂直+水平之混 The patient, female, aged 12, complained of dizziness, left deafness, tinnitus, previous physical health, and no ear disease when suddenly dropping a branch from above into the left external auditory canal while playing in the hospital on July 13, 1981. At that time conscious Severe pain, since then, the volatility of “workers” sound and sustained “gold” sound, left tinnitus, left ear hearing loss, and rotational dizziness and vomiting. After bed rest, no improvement in symptoms, the day of treatment. The first visit examination: auricle, external auditory meatus lesions, obvious congestion of the left tympanic membrane, the upper quadrant of the tension department perforation, through the perforation, see the anterior displacement of the incus incarceration, located in front of the tarsal bone buried in blood clots. See obvious nystagmus, looking to the top, we can see to the right level of spontaneous nystagmus, facial nerve paralysis due to the above, suspected traumatic tympanic membrane perforation, combined ossicular chain detachment, and perilymph fistula, and the day of emergency admission. The next day (14th) pure tone hearing examination was mixed deafness .Balanced function test, Romberg’s sign is negative, Mann check, single foot standing left to dump, can not make stepping examination, no signs of cerebellum and fistula, gaze nystagmus , No obvious nystagmus, nystagmus, visible Vertical + horizontal mixed