耳屏软骨鼓室成形术治疗粘连性中耳炎  

Tragus cartilage tympanoplasty for treatment of adhesive otitis media

作　　者：申玉梅[1] 孙文青[2] 申洪[1] 李永贺[3] 

机构地区：[1]南方医科大学病理学教研室,广东广州510515 [2]河南科技大学第二附属医院耳鼻咽喉-头颈外科,河南洛阳471000 [3]南方医科大学珠江医院耳鼻咽喉-头颈外科,广东广州510280

出　　处：《南方医科大学学报》2010年第6期1382-1384,共3页Journal of Southern Medical University

摘　　要：目的观察耳屏软骨鼓室成形术治疗粘连性中耳炎的疗效。方法 2008年6~2008年10月对18例粘连性中耳炎患者行耳屏软骨置入的鼓室成形术,比较术前和术后1个月、1年的语频听力气骨导差和患者自觉症状改善情况。结果全部患者于术后6周内干耳,17例鼓膜愈合,1例鼓膜前下有裂隙,术前平均气骨导差（0.25、0.5、1.0、2.0 kHz）44.65dB,术后1个月平均气骨导差为33.40 dB,骨气导差值缩小〉10 dB,术后1年平均气骨导差（0.25、0.5、1.0、2.0 kHz）为15.21 dB,骨气导差值缩小〉25 dB。自觉耳闷消失或减轻3/15例、耳鸣消失1/11例、耳鸣减轻10/11例,术后出现高频性耳鸣1/7例,鼓膜外观基本正常17例。结论利用耳屏软骨重建鼓膜治疗分泌性中耳炎是临床可行的治疗方法,但是要注意手术适应证的选择。Objective To evaluate the efficacy of cartilage tympanoplasty in the treatment of adhesive otitis media.Methods From June to October,2008,18 patients with adhesive otitis media（18 ears） were treated with tragus cartilage tympanoplasty.The air-bone gap changes and the self-perceived symptomatic improvement were evaluated at 1 month and 1 year after the operation.Results All the patients showed dry ear within 6 weeks after the operation.Tympanic membrane healing was achieved in 17 cases,and 1 case presented with a inferior-anterior fissure in the tympanic membrane.With the average preoperative air-bone gap（at 0.25,0.5,1.0,and 2.0 kHz） of 44.65 dB,the patients showed an obvious decrease of the air-bone gap by over 10 dB at 1 month after the operation and by over 25 dB at one year.Symptomatic improvements were achieved in these cases,including alleviated ear discomforts（3/15 cases）,total tinnitus relief（1/11 cases）,and alleviated tinnitus（10/11 cases）.High-frequency tinnitus was noted in 1 case（1/7 cases）,and the tympanic membrane appeared normal in 17 cases.Conclusion Tympanic membrane reconstruction using the tragus cartilage can be feasible for treatment of secretory otitis media,but the surgical indications should be carefully controlled.

关 键 词：中耳炎 软骨 鼓室成形术 

分 类 号：R764[医药卫生—耳鼻咽喉科]