耳内镜下经耳道入路治疗局限性上鼓室胆脂瘤  

Transcanal Endoscopic Management of Limited Attic Cholesteatoma

作　　者：杨琼 张全明 曾楠 刘成[1] 李巧珍 杨娟[1] 

机构地区：[1]深圳市南山区人民医院耳鼻喉科,深圳518052

出　　处：《中华耳科学杂志》2017年第4期416-419,共4页Chinese Journal of Otology

摘　　要：目的介绍耳内镜下经耳道入路上鼓室切开重建技术治疗局限性上鼓室胆脂瘤。方法回顾性分析2015年1月~2017年03月间单纯用耳内镜完成的上鼓室胆脂瘤病例,重点介绍手术适应症和手术技术。结果以胆脂瘤病变范围在鼓窦入口以前、未向后越过外半规管凸为标准,共21例患者纳入本研究。手术关键为切开盾板,清除鼓室内胆脂瘤病变,用软骨或软骨-软骨膜复合体重建外耳道。所有患者术后未发生面瘫、脑膜炎、迷路炎及感音性耳聋等并发症,未见胆脂瘤复发。结论耳内镜下经耳道入路上鼓室切开重建技术是有别于传统显微镜手术的另一选择,手术创伤小,且能减少胆脂瘤复发,是值得推广的手术方法。Objective To report transcanal endoscopic atticotomy and reconstruction for management of limited attic cholesteatoma. Methods Data from patients with epitympanic cholesteatoma who received transcanal operation exclusively by endoscopy from January 2015 to March 2017 were analyzed retrospectively. Surgical indications and technique were particularly presented. Results A total of 21 patients were included for cholesteatoma confined anterior to the antrum and not passing the lateral semicircular canal. Key surgical points were scutum removal, clearance of tympanic cholesteatoma and reconstruction of ear canal with cartilage or cartilage-perichonfrium complex. No facial palsy, meningitis, labyrinthitis or sensorineural deafness occurred after operation. Conclusions As a reliable alternative for traditional microscopic surgery, transcanal endoscopic atticotomy and reconstruction is worth to be popularized for its minimal invasiveness and low rate of cholesteatoma recurrence.

关 键 词：胆脂瘤 中耳 内镜 耳道 

分 类 号：R764[医药卫生—耳鼻咽喉科]