Ⅰ期鼓室置管在开放式乳突根治鼓室成形术中的应用  

One-stage tympanic cavity ventilation tube placement in canal wall down tympanomastoidectomy

作　　者：邵永良[1] 周永青[1] 李晓明[1] 陈旭真[1] 高春梅[1] 王玲[1] 李勇[1] 

机构地区：[1]白求恩国际和平医院耳鼻咽喉头颈外科,石家庄050082

出　　处：《临床耳鼻咽喉头颈外科杂志》2016年第8期633-636,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的：探讨鼓室置管在开放式乳突根治鼓室成形术中的应用。方法：对52例中耳炎性病变患者行开放式乳突根治鼓室成形术,术中于后下鼓室处留置通气管,术后12d、1个月、2个月、6个月、1年复诊,术后6个月取出通气管,术后1年观察听力水平及鼓室状况。结果：52例患者完整随访1年。8例患者在术后1-3个月出现脱管;44例术后6个月取出通气管。术后1年,52例患者均干耳;39例鼓膜形态稳定,7例鼓膜内陷,4例鼓室积液,2例鼓膜前下象限穿孔;CT检查：鼓室及咽鼓管骨部含气良好39例,鼓室含气腔较小9例,鼓室及咽鼓管骨部全部堵塞4例;52耳较术前听阈气导平均降低12.5 dB。结论：咽鼓管骨部存在严重狭窄或堵塞患者,行开放式乳突根治鼓室成形术时,可Ⅰ期鼓室置管,手术简单、安全,效果满意。Objective：To research the clinical application of tympanic cavity ventilation tube placement in canal wall down tympanomastoidectomy.Method：There were 52 patients with otitis media received canal wall down tympanomastoidectomy.We placed ventilation tube in posterior hypotympanum during the surgery.After surgery,all patients were followed up in 12 days,1 month,2 months,6 months,and 1 year.The ventilation tubes were withdrew 6 months later,and then the hearing level and tympanic cavity status was evaluated after another half year.Result：All cases were followed up at least 1 year after surgery.Forty-four patients′tubes were removed 6 months later,but other 8 tubes had been extruded within 1 to 3months.After 1 year,all 52 cases of ears were dry;39 patients＇ tympanic membranes were stable,the postoperative complications included tympanic membrane retraction in 7 cases,middle ear effusion in 4 cases,and tympanic membrane perforation at anterior-inferior quadrant in 2 cases;CT examination indicated that 39 patients＇ aeration between tympanic cavity and Eustachian tube bony portion was normal,9 patients＇ tympanic cavity aeration was smaller,and 4 patients＇ cavity was obstructed;52 patients＇ average air conduction thresholds were 12.5 dB lower than that of preoperation.Conclusion：One-stage tympanic cavity ventilation tube placement is a simple,safe and effective method in canal wall down tympanomastoidectomy for middle ear diseases with Eustachian tube severe stenosis or obstruction in bony portion.

关 键 词：鼓室腔 通气管 咽鼓管 鼓室成形术 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]