法医学杂志

法医学杂志 ›› 2018, Vol. 34 ›› Issue (4): 392-395.DOI: 10.12116/j.issn.1004-5619.2018.04.010

• 案例分析 • 上一篇    下一篇

24例外伤后鼓膜穿孔法医学鉴定的回顾性分析

陈  芳1，杨小萍1，刘  霞1，董大安1，周晓蓉2，范利华1   

  1. 1. 司法鉴定科学研究院 上海市法医学重点实验室 上海市司法鉴定专业技术服务平台，上海 200063； 2. 迪安鉴定科学研究院 上海迪安司法鉴定有限公司，上海 200051
  • 发布日期:2018-08-25 出版日期:2018-08-28
  • 通讯作者: 范利华，女，主任法医师，主要从事法医临床学科研与鉴定；E-mail：fanlh@ssfjd.cn 周晓蓉，女，硕士，副主任法医师，主要从事法医临床学科研与鉴定；E-mail：blueforest-rong@163.com
  • 作者简介:陈芳（1985—），女，硕士，主检法医师，主要从事法医临床学研究；E-mail：chenf@ssfjd.cn
  • 基金资助:
    中央级公益性科研院所基本科研业务费资助项目（GY2016G-3）；“十三五”国家重点研发计划资助项目（2016YFC0800 700）；上海市法医学重点实验室资助项目（17DZ2273200）；上海市司法鉴定专业技术服务平台资助项目（16DZ2290900）

Retrospective Analysis of 24 Cases of Forensic Medical Identification on Traumatic Tympanic Membrane Perforations#br#

CHEN Fang1, YANG Xiao-ping1, LIU Xia1, DONG Da-an1, ZHOU Xiao-rong2, FAN Li-hua1   

  1. 1. Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China; 2. Shanghai Di’an Forensic Science Limited Company, Di’an Institute of Forensic Science, Shanghai 200051, China
  • Online:2018-08-25 Published:2018-08-28

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摘要： 目的 研究外伤后鼓膜穿孔的法医学鉴定案件特点，探讨鼓膜穿孔的法医学鉴定要点及评定方法。 方法 对司法鉴定科学研究院2017年受理的24例外伤后鼓膜穿孔案例资料进行回顾性分析，包括鼓膜穿孔的大小、形态、好发部位、愈合时间、愈合方式等。 结果 本研究中，外伤性鼓膜穿孔以小穿孔（＜1/2象限）多见，形态常不规整，以前下象限为主，向心性移行愈合常见，6周内的愈合率达90%。 结论 外伤后鼓膜穿孔的鉴定案件中，重点是确定是否为外伤性以及6周内是否自行愈合，建议伤后每周定期进行鼓膜摄像检查，并在第6周联合应用声阻抗检查，从而提高鉴定的准确性、客观性及科学性。

关键词: 法医学, 创伤和损伤, 鼓膜穿孔, 愈合, 案例分析

Abstract: Objective To study the case characteristics of forensic medical identification of traumatic tympanic membrane perforations, and to discuss the key points of forensic medical identification and evaluations methods for tympanic membrane perforations. Methods Twenty-four cases of traumatic tympanic membrane perforations accepted by the Academy of Forensic Science during 2017 were retrospectively analysed. The data of perforation size, form, predilection site, healing time and healing mode were evaluated. Results For the traumatic tympanic membrane perforations, the study showed that the small size of perforation （<1/2 quadrant） with irregular shape was common. The location of perforations was almost on the anterior and inferior quadrant, and centripetal migration healing was common. The healing rate within 6 weeks was up to 90%. Conclusion In the identification cases of traumatic tympanic membrane perforations, the key is to determine whether it is traumatic and whether it will heal spontaneously within 6 weeks. It is suggested to check the tympanic membrane weekly by an otic endoscope combined with acoustic impedance measurement at the sixth week, which can improve the accuracy, objectivity and scientificity of the identification.

Key words: forensic medicine, wounds and injuries, tympanic membrane perforation, healing, case analysis