外伤性鼓膜穿孔合并圆窗瘘管外淋巴漏较少见,保守性圆窗龛填塞手术可完全治愈。本文报告一例。患者女性、20岁,因双耳耵聍栓塞先行右耳冲洗,后又行左耳冲洗。冲洗时,患者突感左耳痛,并放射至颈部及头部,颈部反射性挛缩。呕吐、耳鸣和眩晕,定向力正常,可自己行走或站立。检查:右耳鼓膜正常;左耳耵聍栓塞。无自发性眼震,耳神经检查无异常。左耳因耵聍栓塞未做瘘管试验,音叉检查示传导性聋。在手术显微镜下将耵聍栓取出,见外耳道正常,鼓膜充血混浊,前下方穿孔,有清液外溢,清洁后耳痛缓解,住院行对症治疗并用抗生素预防感染。12小时后仍有眩晕和脑脊液耳漏,乃于次日行鼓室探查术。术中先取耳垂脂肪和耳屏软骨膜 Traumatic tympanic membrane perforation combined round window fistula outside the lymphatic drainage is rare, conservative round window niche packing surgery can be completely cured. This article reports an example. Female patient, 20 years old, due to binaural embolism embolism first right ear rinse, followed by left ear rinse. Flushing, the patient suddenly felt left ear pain, and radiation to the neck and head, neck reflex contracture. Vomiting, tinnitus and dizziness, normal orientation, walking or standing on their own. Check: right eardrum normal; left ear 耵 聍 embolism. No spontaneous nystagmus, no abnormal auditory canal examination. Left ear embolism due to 耵 未 not fistula test, fork check showed conductive deafness. Surgery under the microscope will remove the bolt, see the external auditory canal normal, tympanic membrane congestion and opacity, perforated below the front, a clear spill, earache ease after cleaning, hospital symptomatic treatment and antibiotics to prevent infection. Dizziness and cerebrospinal fluid otorrhea remained after 12 hours, but tympanometry was performed on the next day. Preoperative ear surgery ear fat and tragus cartilage