乳突根治术后不干耳的临床研究  

Clinical study of the infectd mastoid cavity after mastoidectomy

作　　者：铁木尔.阿布列孜 曾进[1] 马芙蓉[1] 

机构地区：[1]北京大学第三医院耳鼻咽喉头颈外科,北京100191 [2]新疆哈密地区中心医院耳鼻咽喉科,新疆哈密839000

出　　处：《中华耳科学杂志》2010年第3期248-253,共6页Chinese Journal of Otology

基　　金：2008北京市自然科学基金(编号:7082100);2008国家自然基金重大协作项目(编号:90813032);"十一五"国家科技支撑计划(编号:2007BAI18B12)

摘　　要：目的分析研究中耳乳突根治术后不干耳的主要原因,研究再次手术为了获得干耳应该注意的问题。方法对北京大学第三医院耳鼻咽喉头颈外科于2001—2009年间收治入院的资料完整的60例乳突根治术后不干耳患者的临床资料进行回顾性分析。结果再次手术均采用乳突再根治术及开放式鼓室成形术。随访6月～8年,60例患者均获得干耳,干耳率为100%。在手术中发现60例乳突根治术后不干耳患者中,外耳道口狭窄者53例(占88%),胆脂瘤残留者48例(占80%),术腔内肉芽增生者44例(占73.3%),面神经嵴高者40例(占66.7%)。结论乳突根治术后不干耳的主要原因为病变清除不彻底和手术缺陷。乳突根治术后要想获得干耳,术中彻底清除病灶,保证术腔的通风和引流是干耳的基本条件。Objective To study the influence factors on infected mastoid cavity after the mastoidectomy in order to give the advise to the ear surgeon performing the mastoidectomy and tympanoplasty. Methods Clinical data of 60 patients who experienced the revision surgery in the Otolaryngology Department of Peking University Third Hospital from 2001 to 2009 years were retrospectively analyzed. Results 60 patients with the infected mastoid cavity were performed mastoidecty and the canal wall down tympanoplasty. They all gained the permanent dry mastoid cavity after the revision surgery during six months to eight years follow-up. 53 cases （88%） with the stenotic orifice, 48 cases （80%） with residue cholesteatoma, 44 cases （73.3%） with the granulation in the cavity, 40 cases （66.7%） with the higer facial redge had been found. Conclusion The residue disease and defect of the cavity are still the main causes of infected mastoid cavity after the mastoidectomy. In order to gain the permanent dry ear after the middle ear surgery, one must remove all disease in the middle ear; the ventilation of the mastoid cavity after the mastoidectomy should not be ignored.

关 键 词：乳突根治术 胆脂瘤 感染 再次手术 

分 类 号：R764.92[医药卫生—耳鼻咽喉科] R619[医药卫生—临床医学]