Ⅲ期外耳道胆脂瘤再分期治疗的临床疗效观察  

Clinical Efficacy of Restaging Treatment for Stage Ⅲ Ear Canal Cholesteatoma

作　　者：段礼府[1] 鄢斌成 蒋宗玲 魏兴 胡一勇 Duan Lifu;Yan Bincheng;Jiang Zongling(Department of Otorhinolaryngology Head and Neck Surgery,The First People's Hospital of Zigong,Zigong,Sichuan 643000,China)

机构地区：[1]自贡市第一人民医院耳鼻咽喉头颈外科,四川自贡643000

出　　处：《四川医学》2023年第11期1182-1185,共4页Sichuan Medical Journal

摘　　要：目的探讨对Ⅲ期外耳道胆脂瘤进行个体化治疗的方案,以提高疗效及安全性。方法对试验组30例Ⅲ期外耳道胆脂瘤手术患者根据面神经桥是否完整分为Ⅲa期、Ⅲb期,Ⅲa期根据乳突不同气化程度,采用相应的乳突手术+鼓室探查+外耳道后壁重建术,加或不加鼓室成形术,Ⅲb期采用开放式乳突切开+鼓室成形术,用骨粉缩腔,耳后皮瓣复合瓣促进上皮化。术后随访观察6个月,观察术后干耳时间、听力、胆脂瘤复发等指标,与既住病例中选择30例进行对比,评价治疗效果。结果试验组在干耳时间、听力、胆脂瘤复发等指标明显优于对照组。结论将Ⅲ期外耳道胆脂瘤进行再分期治疗,能提高疗效,是一种较好的治疗策略。Objective To explore the individualized treatment for stageⅢear canal cholesteatoma in order to improve efficacy and safety.Methods Thirty patients as experimental group undergoing surgery for stageⅢear canal cholesteatoma were divided intoⅢa andⅢb according to the completeness of facial nerve bridge.According to different degrees of mastoid gasification,corresponding mastoid operation and tympanic exploration and reconstruction of posterior wall of external auditory canal,with or without tympanoplasty,was used in stageⅢa ear canal cholesteatoma.On the other hand,open mastotomy and tympanoplasty and bone meal constriction cavity was used in stageⅢb ear canal cholesteatoma,and composite flap of posterior auricular skin flap was used to promote epithelialization.Postoperative dry ear time,hearing,cholesteatoma recurrence and other indicators were followed up for 6 months,and 30 cases were selected from the resident cases to evaluate the therapeutic effect.Results The experimental group was better than the control group in dry ear time,hearing and cholesteatoma recurrence.Conclusion Restaging of stageⅢear canal cholesteatoma can improve the curative effect and is a good treatment strategy.

关 键 词：Ⅲ期外耳道胆脂瘤 外耳道后壁重建 完桥式乳突切开 耳后皮瓣复合瓣 

分 类 号：R764.1[医药卫生—耳鼻咽喉科]