耳内镜微创治疗中耳胆脂瘤的临床效果观察  

Observation of clinical effect of minimally invasive otoendoscopy in treatment of middle ear cholesteatoma

作　　者：马美[1] 刘冰[1] Ma Mei;Liu Bing(Department of ENT,Xuzhou Central Hospital,Jiangsu,Xuzhou,221009,China)

机构地区：[1]徐州市中心医院,江苏徐州221009

出　　处：《中国医学文摘（耳鼻咽喉科学）》2022年第5期16-18,共3页Chinese Medical Digest(Otorhinolaryngology)

基　　金：徐州市科技局重点研发计划(社会发展)(项目编号:KC20135)。

摘　　要：目的探讨耳内镜微创治疗中耳胆脂瘤的临床疗效及安全性。方法回顾性分析我院2018年4月~2021年4月期间收治的80例中耳胆脂瘤患者的临床资料,所有患者均在而内镜下经外耳道入路行鼓室探查术、鼓室成形术及乳突根治术,观察手术疗效、鼓膜愈合率、手术前后气导听阈和气骨导差变化。结果80例患者均顺利完成手术,手术方式:鼓室探查术+鼓室成形术32例,鼓室探查术+鼓室成形术+改良乳突根治术44;改良乳突根治再修正术4例。术后3个月内鼓膜愈合77例,愈合率96.25%,3例因感染继发穿孔,占比3.75%,均在耳内镜下处理后于半年内完全痊愈。术后无面瘫、眩晕、感音神经性聋等严重并发症发生;术后三个月平均气导听阈(49.12±20.01)dB HL、气骨导差(35.11±12.36)dB HL与术前测定值(34.12±22.01)dB HL、(17.56±10.25)dB HL比较,差异有统计学意义(P<0.05)。结论耳内镜微创治疗中耳胆脂瘤疗效确切,术中出血少,术后鼓膜愈合率高,听力改善效果显著,安全性高。Objective To probe into the clinical effect and safety of minimally invasive otoendoscopy in treatment of middle ear cholesteatoma.Methods 80 cases of patients with middle ear cholesteatoma and who treated in our hospital from April 2019 to April 2021 were analyzed retrospectively,and all patients underwent tympanoplasty,tympanoplasty and radical mastoidectomy through the external auditory canal under endoscope.Then,the clinical effect,tympanic membrane healing rate,air conduction hearing threshold and air bone conduction difference before and after operation were observed.Results All 80 patients successfully completed the operation.The operation method was as follows:32 cases of tympanoplasty+tympanoplasty,44 cases of tympanoplasty+tympanoplasty+modified radical mastoidectomy;4 cases of modified radical mastoidectomy and revision.Within 3 months after operation,77 cases of tympanic membrane healed,the healing rate was 96.25%,and 3 cases were secondary perforation due to infection,accounting for 3.75%.All of them were completely cured within half a year after treatment under Otoendoscope.There were no serious complications such as facial paralysis,vertigo and sensorineural deafness;The mean air conduction hearing threshold(49.12±20.01)dB HL and air bone conduction difference(35.11±12.36)dB HL were compared with the preoperative measured values(34.12±22.01)dB HL and(17.56±10.25)dB HL,and the difference was statistically significant(P<0.05).Conclusion The clinical effects of minimally invasive otoendoscopy in treatment of middle ear cholesteatoma are accurate,which the intraoperative bleeding are less,the postoperative tympanic membrane healing rate are high,and the hearing improvement effect are significant,the safety are high.

关 键 词：耳内镜 中耳 胆脂瘤 微创手术 

分 类 号：R76[医药卫生—耳鼻咽喉科]