改良乳突根治术合后上壁重建对上鼓室胆脂瘤型中耳炎患者听力改善及复发率的影响  

Effect of Modified Mastoidectomy Combined with Posterior Superior Wall Reconstruction on Hearing Improvement and Recurrence Rate in Patients with Upper Tympanic Cholesteatoma Otitis Media

作　　者：李戍军 陈福权 王宝岗 孙波 韩璐荣 韩宁 LI Shu-jun;CHEN Fiu-quan;WANG Bao-gang;SUN Bo;HAN Lu-rong;HAN Ning(Department of Otolaryngology Head and Neck Sugery,986 Hospital of Air Forece,Xi'an,Shaanxi,710054,China;Departnent of Otolaryngology Head and Neck Surgery,Xijing Hospital of Air Force Military Medical University,Xi',Shanxi,710032,China;Department of Otolarmngology,986 Hospital of Air Force,Xi'an,Shaanxi,710054,China)

机构地区：[1]空军第九八六医院耳鼻咽喉头颈外科,陕西西安710054 [2]空军军医大学西京医院耳鼻咽喉头颈外科,陕西西安710032 [3]空军第九八六医院耳鼻喉科,陕西西安710054

出　　处：《现代生物医学进展》2022年第14期2691-2694,2704,共5页Progress in Modern Biomedicine

基　　金：陕西省科技厅重点产业创新链(群)-社会发展领域(2021ZDLSF02-12)。

摘　　要：目的:探讨改良乳突根治术联合后上壁重建对上鼓室胆脂瘤型中耳炎患者听力改善及复发率的影响。方法:选取本院2015年5月-2020年10月收治的62例上鼓室胆脂瘤型中耳炎患者作为研究对象,随机将其分为改良组(n=31)和对照组(n=31)。改良组采用改良乳突根治术联合后上壁重建进行治疗,对照组采用乳突根治术进行治疗,对比两组患者手术前后听力情况、术后干耳所需时间等指标。结果:治疗前两组患者的气骨导差、气导听阀对比无明显差异(P>0.05),治疗后均降低,并且改良组低于对照组(P<0.05);改良组患者术后并发症发生率较对照组低(P<0.05);改良组患者的术后2周、4周、8周干耳率较对照组高(P<0.05),术后干耳所需时间低于对照组(P<0.05);改良组治疗总有效率较对照组高(P<0.05)。结论:将改良乳突根治术联合后上壁重建应用于上鼓室胆脂瘤型中耳炎患者当中,可提高患者听力,降低并发症,还可提高患者干耳率,缩短干耳时间,降低复发率,提高临床疗效,本研究值得临床借鉴。Objective:To investigate the effect of modified mastoidectomy combined with posterior superior wall reconstruction on hearing improvement and recurrence rate in patients with upper tympanic cholesteatoma otitis media.Method:Select 62 cases of cholesteatoma admitted in our hospital from May 2015 to October 2020 Patients with upper tympanic cholesteatoma otitis media were taken as the research objects,and they were segmented into improved group(n=31)and matched group(n=31).The improved group was treated with modified radical mastoidectomy combined with posterior upper wall reconstruction for upper tympanum cholesteatoma otitis media,while the matched group was treated with radical mastoidectomy for upper tympanum cholesteatoma otitis media.The hearing status before and after surgery and the time required for dry ear after surgery were compared between these groups.Results:Before treatment,there was no difference in the difference between these groups(P>0.05),all decreased after treatment,and the improved group was lower than the matched group(P<0.05);the incidence of postoperative complications in the improved group was lower than matched group(P<0.05);The dry ear rate of 2,4 and 8 weeks after operation in improved group was higher than that in matched group(P<0.05),and the time required for dry ear after operation was lower than that in matched group(P<0.05);the total effective rate of treatment in the improved group was higher than that in the matched group(P<0.05).Conclusion:The application of modified mastoidectomy combined with posterior superior wall reconstruction in patients with upper tympanic cholesteatoma otitis media can improve patients’hearing,reduce complications,improve the rate of dry ear,shorten the time needed for dry ear,reduce the recurrence rate and improve the clinical efficacy.This study is worthy of clinical reference.

关 键 词：改良乳突根治术 后上壁重建 胆脂瘤型中耳炎 

分 类 号：R764[医药卫生—耳鼻咽喉科]