摘要
目的 :探讨乳突腔充填术在开放式鼓室成形术中对恢复生理性外耳道功能的作用。方法 :对行开放式鼓室成形术的 85例 85耳胆脂瘤型中耳炎 ,以乳突皮质骨、同种异体软骨和 U形肌骨膜瓣同期行乳突腔充填。听骨链重建情况 :因骨导域值增高或行阶段性手术未作听骨链重建 10耳 ,鼓室成形术改良 型 40耳 ,改良 型35耳。结果 :总听觉改善率 76 % ,其中改良 型为 80 % ,改良 型为 71.4%。术后干耳率为 97.6 % ,平均干耳时间(19.86± 5 .31) d。术后随访半年以上 ,具有圆滑外耳道以及良好自净作用的占 89.4%。未见胆脂瘤复发病例。结论 :对没有条件行完壁式鼓室成形术的胆脂瘤型中耳炎 ,行乳突充填可以有效地克服开放式鼓室成形术破坏生理外耳道结构的不足 ,保存外耳道皮肤的自净作用 ,提高患者术后的生活质量。
Objective:The role mastoid cavity plombage played in restoring physiological function of external meatus in open method tympanoplasty was studied.Method:85 cases of cholesteatoma otitis media were performed open method tympanoplasty with the broken bits of their own mastoid process cortex, homological costal cartilage or U shape periosteum connective tissue valve. And plombage was performed at the same time.The reconstruction of ossicular chain (type 0 tympanoplasty): 10 ears did not undergo reconstruction due to increase ment of bone conduction threshold or were in preparation for the second phase operation; 40 ears underwent type Ⅲ tympanoplasty; 35 ears underwent type Ⅳ tympanoplasty.Result:The total improvement rate of hearing was 76%, among which 80% were performed type Ⅲ tympanoplasty and 71.4 % underwent type Ⅳ tympanoplasty. After operation, the time waited till dry ears was 19.8 ± 65.31 days and the dry ears rate was 97.6 % (83/85). Six months after operation, 89.4 % (76/85) had smooth external meatus and fine self cleaning function and no recurrence was found.Conclusion:As to cholesteatoma otitis media that could not be performed closed method tympanoplasty, U shape periosteum connective tissue valve and mastoid process cortex were used. Mastoid cavity plombage with homological costal cartilage could effectively overcome the shortcomings of destruction of physiological structure of external meatus caused by open method tympanoplasty, the self cleaning function of skins of external meatus was remained and the life quality of patients after operation was increased.
出处
《临床耳鼻咽喉科杂志》
CSCD
北大核心
2001年第8期363-365,共3页
Journal of Clinical Otorhinolaryngology
