上鼓室开放同期鼓室成形术中残余听骨的再利用  

Reuse of residual ossicles in tympanoplasty over the same period atticotomy

作　　者：张宝林[1] 王廷础[2] 

机构地区：[1]解放军空军总医院耳鼻喉科,北京100142 [2]山东大学卫生部耳鼻喉科学重点实验室,山东济南250012

出　　处：《临床军医杂志》2010年第6期992-994,共3页Clinical Journal of Medical Officers

摘　　要：目的观察上鼓室开放同期鼓室成形术中自体听骨及乳突皮质骨的利用效果及自体凝血块作为重建听骨链支撑材料的效果。方法对23耳局限性胆脂瘤型中耳炎行上鼓室开放及鼓室成形术,术中封闭鼓窦,开放上鼓室,术后随访6～24月。结果 23耳经纯音测听检查语言频率听力3耳比术前提高25 dB,7耳提高20 dB,7耳提高15 dB,6耳提高10 dB。未见胆脂瘤复发、鼓膜再穿孔或移植骨被排出。结论自体砧骨或乳突皮质骨是良好的听骨链重建材料,经过塑形完全可以再次应用到鼓室成形术中。自体血凝块加明胶海绵小碎块是取材方便的重建听骨链的支撑材料。封闭鼓窦及开放上鼓室有利于上鼓室上皮化。Objective Observe the application effect of autologous auditory ossicles and mastoid cortex in ossicular chain reconstruction and autologous blood clot as supporting materials in tympanoplasty over the same period atticotomy.Methods Sealed the tympanic sinus,opened epitympanum,23 ears with epitympanic cholesteatoma were surgical treated with the tympanoplasty over the same period atticotomy,postoperative visiting over 6-24 months.Results Hearing level of 3 ears were improved with 25 dB,7 ears with 20dB,7 ears with 15dB,6ears with 10dB,no cholesteatoma recurred、tympanic membrane re-perforated and graft discharged.Conclusion Self-incus and mastoid cortex can be reused in tympanoplasty after re-shaped,are good stuff in ossiculoplasty.Mixture of small pieces gelatin sponge and self-thrombus is good support stuff of reconstructing ossicle chain.Sealing tympanic sinus and atticotomy benefic to the epithelialization of attic cell mucosa.

关 键 词：上鼓室 鼓室成形术 听骨链 乳突皮质骨 自体血凝块 支撑材料 胆脂瘤型中耳炎 重建材料 胆脂瘤复发 语言频率 术后随访 明胶海绵 利用效果 鼓窦 封闭 纯音测听 移植骨 上皮化 凝血块 局限性 

分 类 号：R82[医药卫生—临床医学]