外耳道后壁和上鼓室外侧壁重建并鼓室成形术的临床应用  

Observation on the clinical implications of synchronized reconstruction with the posterior bone-wall of auricular meatus and outer wall of the attic in tympanoplasty

作　　者：徐永田[1] 张抗美[1] 冯益进[1] 李素梅[1] 李羚[1] 黄家英[1] 郑玉美[1] 王玲玲[1] 

机构地区：[1]合肥市第一人民医院耳鼻咽喉科

出　　处：《中国中西医结合耳鼻咽喉科杂志》2009年第2期77-79,共3页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的探讨外耳道后壁和上鼓室外侧壁同期重建在鼓室成形术中的意义。方法30例（31耳）慢性化脓性中耳炎患者，骨性外耳道预先取骨备用。清除病灶后进行外耳道后壁和上鼓室外侧壁重建，并行I期行鼓室成形术。结果术后随访3个月～1年，31耳均获得干耳；外耳道形态接近正常，保留含气乳突腔。术后平均气导听阈提高〉20dB以上者22耳，提高10-20dB者8耳，提高〈10dB者1耳。结论同期行外耳道后壁和上鼓室外侧壁重建并I期行鼓室成形术，有助于修复乳突根治术后遗留的乳突空腔或大外耳道，有助于改善听力。Objective To explore the clinical implications of synchronized reconstruction with the posterior bone-wall of auricular meatus and outer wall of the attic in tympanoplasty based on a clinical trial. Methods Included in this study were 30 cases （31 ears） with chronic suppurative otitis media, with their lesion treated by one stage of tympanoplasty combined with posterior bone-wall reconstruction of the auditory canal and outer wall of the attic. During the operation of tympanoplasty, the bone was beforehand collected from the posterior bone-wall of auricular meatus at first. And then, reconstructed were the posterior bone-wall of canal and the outer wall of the attic. Results By the end of following up period lasted for 3 months to one year, suppurative otorrhea were observed stopped among all these treated ears, with their canal wall almost getting to the normal shape and with their gas-containing mastoid cavity remained. The post-operative hearing threshold level of air conduction eas elevated more than 20 dB in 22 ears, improved 10--20 dB in 8 ears and increased less than 10 dB in 1 ear. Conclusions One stage of tympanoplasty with simultaneous reconstruction of posterior bone-wall of external canal and outer wall of the attic can effectively promote heating elevation for cases with chronic suppurative otitis media treated, with more ideal mastoid cavity and external canal shape for such cases.

关 键 词：重建术 外耳道后壁 上鼓室外侧壁 鼓室成形术 疗效 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]