乳突开放术后自体骨屑填塞重建外耳道后壁对患者听力的影响  

Effect of autogenous bone powder tamponade for reconstruction of the back wall of external acusticus canal on hearings of patients after mastoid surgery

作　　者：朱水英[1] 官树雄[1] 冯锡坚[1] 蔡建良[1] 王金[1] 刘月华[1] ZHU Shuiying;GUAN Shuxiong;FENG Xijian(E.N.T.Department of Houjie Hospital,Dongguan 523945,China)

机构地区：[1]东莞市厚街医院耳鼻咽喉科,广东东莞523945

出　　处：《华夏医学》2018年第4期115-117,共3页Acta Medicinae Sinica

基　　金：东莞市社会科技发展课题资助项目(2014108101017)

摘　　要：目的:探讨乳突开放术后自体骨屑填塞重建外耳道后壁对患者听力影响。方法:选取我科收治的70例累及鼓室的中耳胆脂瘤患者(70耳),随机分为观察组与对照组各35例。观察组患者采用自体骨粉填塞重建外耳道后壁,不行耳甲腔成形术;对照组患者在手术中采用传统的明胶海绵和碘仿纱填塞,常规行耳甲腔成形术。结果:观察组患者的术后局部渗液量水平明显低于对照组(P<0.05),术后第3天的耳堵塞感评分明显低于对照组(P<0.01),术后3个月、6个月、12个月的气骨导差皆低于对照组(P<0.01)。结论:乳突开放术后自体骨粉填塞重建外耳道后壁可以更为有效地降低术后局部渗液量水平,降低术后耳堵塞感,且有利于近期和远期听力水平的改善,值得推广。Objective： To investigate the effect of autogenous bone powder tamponade for reconstruction of back wall of external acousticus canal on hearings of patients after mastoid surgery. Methods： 70 cases with middle ear cholesteatoma involving tympanic chamber were selected and randomly divided into the observation group（n = 35） and control group（n = 35）. Patients in the observation group were treated with autogenous bone powder tamponade to reconstruct the posterior wall of the external auditory canal,without auricular cavity angioplasty; while the other patients in the control group were treated with conventional otoplasty with gelatin sponge and iodoform gauze tamponade. Results： The postoperative local exudate level in the observation group was significantly lower than that in the control group（P〈0.05）. The score of ear clogging on the 3 rdday after operation was significantly lower than that in the control group（P〈 0.01）. 3 months,6 months and 12 months after operation,the air bone gaps were all lower than those of control group（P〈0.01）. Conclusion： The reconstruction of the posterior wall of the external auditory canal with autogenous bone powder after mastoidectomy can effectively reduce the level of local exudate,reduce the sense of ear clogging,and be beneficial to the improvement of the hearing level in the near and long term,which is worth popularizing.

关 键 词：乳突开放术 自体骨粉 重建 外耳道后壁 听力 

分 类 号：R764.92[医药卫生—耳鼻咽喉科]