文档介绍：开放式鼓室成形术治疗胆脂瘤中耳炎

【摘要】探讨开放式鼓室成形术治疗胆脂瘤中耳炎的疗效。方法:对23例胆脂瘤中耳炎患者行开放式鼓室成形术。结果:随访1 3年,23耳全部干耳,无胆脂瘤复发, 无眩晕和面瘫并发症。20例移植筋膜成活,2例鼓膜再穿孔,1例鼓膜疤痕内陷。术后纯音测听语言频率气导平均听阈,提高25 30?dBHL 5耳,提高15 20?dBHL 13耳,提高10?dBHL 2耳,无变化3耳。结论:为胆脂瘤型中耳炎患者行开放式鼓室成形术,能根治病变,听力恢复效果好,复发率低,是一种较为实用的手术方法。
【关键词】鼓室成形术开放式胆脂瘤中耳炎
[ABSTRACT] Objective: To investigate the effect of open tympanoplasty for patients with cholesteatoma of the middle ear. Method: Twentythree ears with cholesteatoma were treated by open tympanoplasty. Results: During a followup of one to three years, all had dry ears without relapse and vertigo or facial paralysis. Among them, 20 cases had normal tympanic membranes, 2 had perforation, and 1 had a sunken tympanic membrane. Hearing was improved by 25 to 30?dBHL in 5 ears, 15 to 20?dBHL in 13 ears, 10?dBHL in 2 ears, and not improved in 3 ears. Conclusion: Open tympanoplasty should be carried out in treating otitis media with cholesteatoma to improve the hearing and decrease relapse.
[KEY WORDS] Tympanoplasty, open; Cholesteatoma; Otitis media 随着耳显微外科技术的快速发展及对胆脂瘤发病规律、病因的认识,胆脂瘤中耳炎的手术治疗,已由过去的以清除病灶、防止并发症为主,逐步转向在彻底清除病灶的同时重建传音结构。我科2003 2005年对23例胆脂瘤中耳炎患者行开放式鼓室成形术(乳突根治伴鼓室成形),随访1 3年,取得了较好疗效,报告如下。
1 资料与方法
一般资料 23例中,男15例,女8例,12 63岁,病程3 20年,均有反复耳流浓病史和听力下降症状,全身及局部应用抗生素治疗无效。全部患者术前行纯音测听,气导下降>40?dBHL,气骨导差>25?dBHL,颞骨CT检查示胆脂瘤存在于后鼓室、上鼓室、鼓窦和乳突腔。鼓膜修补用颞肌筋膜,听力重建材料为自体听骨、乳突皮质骨和美敦力人工听骨。
手术方法手术在局麻或全麻下进行,根据CT显