慢性中耳乳突炎性疾病不同手术方式的疗效分析  

Curative Effects of Different Surgical Procedures for Chronic Middle Ear and Mastoid Inflammatory Lesions

作　　者：阿依恒.曲库尔汗[1] 王远强 木拉提.阿地力 冯娟[1] 

机构地区：[1]新疆医科大学第一附属医院耳鼻咽喉科,乌鲁木齐830054 [2]新疆博州人民医院耳鼻咽喉科,博乐833400

出　　处：《中国微创外科杂志》2015年第8期726-728,733,共4页Chinese Journal of Minimally Invasive Surgery

基　　金：新疆自治区自然科学基金(项目编号:2013211A098)

摘　　要：目的探讨慢性中耳乳突炎性疾病的不同显微手术方式的疗效。方法 2009年1月～2013年10对110例慢性中耳乳突炎性病变,包括中耳胆脂瘤和慢性化脓性中耳炎,根据病变范围显微镜下分别施行完壁式乳突根治或同时鼓室成形术和开放式乳突根治术,观察术后干耳恢复情况、并发症、复发以及术后听力改善程度等。结果完壁式乳突根治术51例,其中46例同时行鼓室成形术,6例行二期人工假体植入术。2例中耳胆脂瘤术后1年复发,第2次行开放式手术。术后听力提高〉25 d B 27例,〉15 d B 16例,听力减退1例。开放式乳突根治术59例,其中31例行小鼓室成形术。1例开放式手术后不干耳,换药2个月后获得干耳,其余均获得干耳。术后听力提高〉15 d B 5例,听力减退3例,余听力无改善。结论根据病例选择适当的术式可以获得满意的临床疗效。Objective To study the curative effects of microscopic surgery for inflammatory lesions in the middle ear and mastoid by using different surgical procedures. Methods There were 110 cases of inflammatory lesions in the middle ear and mastoid from January 2009 to October 2013, including middle ear cholesteatoma and chronic suppurative otitis media. According to the scope of the lesions, either canal wall up mastoidectomy with or without tympanoplasty or open mastoidotympanectomy was carried out. Postoperative ear recovery, complications, recurrence, and hearing improvement were observed. Results The canal wall up mastoidectomy was performed in 51 cases, 46 of which received tympanoplasty simultaneously and 6 of which underwent a secondary artificial prosthesis implantation. Two patients with middle ear cholesteatoma experienced recurrence 1 year after surgery, and were given a secondary open operation. Postoperatively, bearing improvement was achieved 〉 25 dB in 27 eases, 〉 15 dB in 16 cases, and hearing loss was seen in 1 case. There were 59 cases of open mastoidectomy, including 31 cases of small tympanic cavity plasty. After open surgery, dry ear was not achieved in 1 ease, which was cured after 2 months of dressing changes. The dry ear was achieved in all the remaining cases, with hearing improvement 〉 15 dB in 3 cases and hearing loss in 3 cases. Conclusion According to different lesions in the middle ear and mastoid, different operative methods can be used to obtain satisfactory clinical curative effects.

关 键 词：中耳炎性病变 中耳胆脂瘤 慢性中耳炎 乳突根治术 鼓室成形术 显微手术 

分 类 号：R764.92[医药卫生—耳鼻咽喉科]