鼓室成型术中齿突及上鼓室前隐窝处理的临床意义  

Clinic Signification of Cog and Anterior Epitympanic Recess in Tympanoplasty

作　　者：张家雄[1] 邹文焘[1] 吴医婕[1] 

机构地区：[1]上海同济大学附属第十人民医院耳鼻咽喉科,200072

出　　处：《解剖与临床》2010年第6期429-431,共3页Anatomy and Clinics

摘　　要：目的：探讨鼓室成型术中齿突及上鼓室前隐窝处理的临床意义.方法：采用改良乳突根治＋鼓室成型术治疗37例慢性中耳乳突炎,其中胆脂瘤型23例、肉芽型14例.术中对齿突进行解剖观察,并对其前方的上鼓室前隐窝病灶进行探察与处理.结果：术中见齿突明显下垂的长骨嵴型者9例（24.32%）,短骨嵴型28例 上鼓室前隐窝发现胆脂瘤22例、水肿肉芽13例、另有2例黏膜光滑.37例干耳时间为1～3月,平均1.5月.听力以0.5 Hz、1.0 Hz、2.0 Hz（听力级）3个语言频率气导及气骨导差缩小的平均值评定.术后平均气骨导差（15.27±5.00）dB,较术前（34.95±7.52 ）dB明显缩小（P＜0.01）.结论：齿突前方为上鼓室前隐窝,常是胆脂瘤或肉芽病灶隐匿部位,鼓室成型术中切除齿突和开放上鼓室前隐窝有利于彻底清除病灶,可减少术后病灶残留和复发.Objective ： To study the clinic signification of the treatment on cog and anterior epitympanic recess in tympanoplasty, nethods：37cases with chronic otitis media underwent open technical tympanoplasty were analyzed in our department from 2003 to 2004. Results ：There were long cog in 9 cases and short cog in 28 cases. 35 eases found cholesteatoma and/or granulation in the anterior epitympanic recess. The average air - bone gap （0.5,1.0,2.0Hz hearing loss） was 34.95 ±7.52 dB before operation and 15.27 ± 5.00dB after operation（ t = 3.56, P 〈 0.01 ）. Conclusions ： It is important to drill the cog and clearance the cholesteatoma and/ or granulation in the anterior epitympanic recess during the operation. This may decline and avoid the recurrence of otitis media after operation.

关 键 词：中耳炎 听力 齿突 上鼓室前隐窝 鼓室成型术 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]