“小鼓窦”型慢性化脓性中耳炎行改良乳突根治术的探讨  

Modified radical mastoidectomy on "drum sinus" type chronic suppurative otitis media:our experience

作　　者：娄麟[1] 祝佼 吕丹[1] 陈秋蓉[1] 杨济民[1] 秦学玲[1] 

机构地区：[1]四川大学华西医院耳鼻咽喉头颈外科,成都610041 [2]成都天府新区人民医院耳鼻咽喉科

出　　处：《临床耳鼻咽喉头颈外科杂志》2016年第13期1068-1071,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨"小鼓窦"型慢性化脓性中耳炎(CSOM)行改良乳突根治术的手术处理方式。方法:测量54例CSOM患耳鼓窦大小、脑膜板低垂值及乙状窦前移值,确定"小鼓窦"类型的判定标准;对符合标准的"小鼓窦"型CSOM行经上鼓室径路的改良乳突根治术及鼓室成形术。术后随访3个月,记录其干耳时间、修补鼓膜的生长情况及术后有无眩晕、面瘫、脑脊液耳漏等并发症发生。结果:54例CSOM患者中符合"小鼓窦"型判定标准者有29例,失访2例,纳入研究者27例。经采用该研究手术处理方式的27例"小鼓窦"型CSOM患者术后3个月干耳率为81.5%,鼓膜存活良好率为77.8%;术后出现眩晕3例,无一例出现面瘫、脑脊液耳漏等并发症。结论:对"小鼓窦"型CSOM行改良乳突根治及鼓室成形术时可采取经上鼓室径路倾斜开放上鼓室的入路方式。Objective：To our experience of modified radical mastoidectomy on ＂drum sinus＂ type chronic suppurative otitis media.Method：We measured the size of tympanic sinus,the extent of meningeal plate lowering and the extent of sigmoid ante-displacement in 54 patients of chronic suppurative otitis media,and determined the criterion of ＂drum sinus＂.The patients who comply with the criterion received modified radical mastoidectomy and tympanoplasty via epitympanum approach.The patients were followed up for at least 3months,The time of dry ear,growth of repaired tympanic membrane,and any complications such as dizziness,facial paralysis,cerebrospinal fluid leakage were recorded.Result：Twenty-nine out of the 54 CSOM patients complied with the criterion of drum sinus.Two cases were lost to follow-up.Therefore,27 cases were included in the study.Three months after the operation,the rate of dry ear was 81.5% Tympanic membrane was successfully repaired in 77.8% of the patients.Three cases had dizziness after operation.No facial paralysis or cerebrospinal fluid leakage was observed.Conclusion：For ＂drum sinus＂ type chronic suppurative otitis media,the modified radical mastoidectomy and tympanoplasty via epitympanum approach can be taken.

关 键 词：中耳炎 伴渗出液 乳突根治术 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]