摘要
目的探讨中耳胆脂瘤和慢性化脓性中耳炎术式选择及临床效果。方法对110例中耳乳突病变,包括中耳胆脂瘤和慢性化脓性中耳炎,根据范围显微镜下实施完壁式或开放式乳突根治,部分同时鼓室成形术,随访术后干耳状况、并发症、复发情况以及术后听力改善程度等。结果 110例患者中66例中耳胆脂瘤、44例慢性化脓性中耳炎,出现颅内外并发症者7例。手术方式:51例(46.36%)行完壁式乳突根治术,46例(41.81%)同时行鼓室成形术,59例(53.64%)行开放式乳突根治术。完壁式乳突根治术后听力提高>25 dB 37例(33.64%),>15 dB 14例(12.72%);开放式乳突根治术后听力提高>15 dB 5例(4.55%),听力减退4例(3.64%),比较手术前后言语频率区平均听阈,差异有统计学意义(P<0.05)。术后随访1年发现开放式和完壁式两组胆脂瘤复发共4例。结论中耳胆脂瘤与慢性化脓性中耳炎通过选择恰当手术方式可获得较好的临床疗效。
OBJECTIVE To evaluate the choice of microsurgical treatment modalities and it＇s clinicaleffect on middle ear cholesteatoma and chronic suppurative otitis media. METHODS 110 cases with middle ear cholesteatoma and chronic suppurative otitis media were analysed which performed canal Wall up mastoidectomy and canal wall down mastoidotympanectomy or at the same time tympanoplasty depending on lesion extent and the recovery time, complications, recurrence and postoperative hearing improvement were followed-up. RESULTS 110 cases were reviewed including 66 cases of middle ear cholesteatoma, 44 cases of chronic suppurative otitis media. Among these 51 cases undergone canal wall up mastoidotympanectomy accounting for 46.36%, 46 case undergone tympanoplasty, accounting for 41.81%. 59 cases undergone canal wall down mastoidectomy, accounting for 53.64%. In the canal wall up mastoidectomy group, 37 ears got hearing improvement 〉25 dB（33.64%）, 〉15 dB 14 ears（12.72%）, while in the canal wall down mastoidectomygroup, 5 ears got hearing improvernent〉15 dB（4.55%）, 4 ears hearing loss（3.64%）, statistically significant difference exist in preoperative and postoperative speech frequency of average hearing threshold. We have found 4 cases of recurrence with cholesteatoma after 1 year follow-up. CONCLUSION According to different lesions of middle ear and mastoid, different operative methods can be used to obtain the corresponding clinical curative effect.
出处
《中国耳鼻咽喉头颈外科》
CSCD
2017年第7期343-346,共4页
Chinese Archives of Otolaryngology-Head and Neck Surgery
关键词
胆脂瘤
中耳
中耳炎
化脓性
耳外科手术
临
床方案
对比研究
Cholesteatoma, Middle Ear
Otitis Media,Suppurative
Otologic Surgical Procedures
ClinicalProtocols
Comparative Study
