胆脂瘤型和骨疡型中耳炎Ⅰ期鼓室成形术的疗效观察  

Evaluation of healing effect for simultaneously tympanoplasty intreating chronic suppurative otitis media with cholesteatomaand/or granulation tissue

作　　者：朱富高[1] 张秋贵[1] 于海玲[1] 张晓恒[1] 于爱华[1] 

机构地区：[1]青岛大学医学院附属医院耳鼻咽喉科,山东青岛266003

出　　处：《临床耳鼻咽喉科杂志》2004年第9期547-548,共2页Journal of Clinical Otorhinolaryngology

摘　　要：目的 :探讨胆脂瘤型和骨疡型中耳炎Ⅰ期鼓室成形术的可行性及疗效影响因素。方法 :5 2例 (5 2耳 )慢性化脓性中耳炎 (胆脂瘤型 30耳 ,骨疡型 2 2耳 )患者在清除病变的同时行鼓室成形术 ,其中单纯鼓室成形术 12耳 ,乳突根治加鼓室成形术 4 0耳。结果 :全部病例均干耳 ,无一例胆脂瘤复发。语频段听力提高 30dB以上者 5耳 ,提高 2 0～ 2 9dB者 9耳 ,提高 10～ 19dB者 31耳 ,小于 10dB者 7耳 ,无听力下降者。结论 :胆脂瘤型和骨疡型中耳炎可行Ⅰ期鼓室成形术 ,鼓膜有效振动面积、镫骨及镫骨底板的活动度是影响听力的重要因素 ,咽鼓管功能不良是手术失败的主要原因。Objective:This study was designed to discuss possibility and factors influencing healing effect for simultaneously tympanoplasty of chronic suppurative otitis media with cholesteatoma and/or granulation tissue.Method:For 52 cases with chronic suppurative otitis media with cholesteatoma (30 ears) and/or granulation tissue(22 ears), cleaning lesion with simultaneously tympanoplasty was surgical procedure, among them, 12 ears treated with single tympanoplasty, 40 ears treated with mastoidectomy and tympanoplasty.Result:All cases had dry ears without recurring cholesteatoma.Among them, hearing of 5 patients improved more than 30 dB, 9 ears improved from 20 to 29 dB, 31 ears improved from 10 to 19 dB and 7 ears improved less than 10 dB. Hearing of no cases reduced than that in preoperation.Conclusion:Simultaneously tympanoplasty would be carried out possible in treating chronic suppurative otitis media with cholesteatoma and/or granulation tissue. There were two important factors influencing hearing improvement, which concluded effective area of tympanic membrane concussion, activity of stapes and/or stapes footplate. The main cause for failure in hearing improvement would be eustachian tube obstruction.

关 键 词：中耳炎 化脓性 鼓室成形术 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]