伴有真菌性外耳道炎的慢性化脓性中耳炎行I型鼓室成形术的临床疗效  

Clinical effect of type I tympanoplasty for chronic suppurative otitis media with external ear canal fungal infection

作　　者：张思思 周宇 陈天宏 林川耀[1] 马登滨[1] ZHANG Sisi;ZHOU Yu;CHEN Tianhong;LIN Chuanyao;MA Dengbin(Department of Otolaryngology Head and Neck Surgery,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Jiangsu Provincial Medical Key Discipline(Laboratory),Research Institute of Otolaryngology,Nanjing,Jiangsu,210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院耳鼻咽喉头颈外科,江苏省医学重点学科,南京鼓楼医院耳鼻咽喉研究所,江苏南京210008

出　　处：《中国耳鼻咽喉头颈外科》2024年第11期708-711,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：国家自然科学基金重大项目(82192862);江苏省重点研发计划(BE2023653);江苏省医学重点学科/实验室(ZDXK202243)。

摘　　要：目的观察伴有真菌性外耳道炎的慢性化脓性中耳炎患者行内镜下I型鼓室成形术的临床疗效。方法根据外耳道及鼓室黏膜的症状特点,将80例患者分为干耳无真菌组、干耳伴真菌组、湿耳无真菌组、湿耳伴真菌组4组。记录其临床特点。伴有真菌性外耳炎的患者围手术期给予药物处理。术后6个月修补的鼓膜未愈合、移植物再发生穿孔和/或持续不能干耳被认为是修补失败。结果本次研究共纳入80例患者,四组患者鼓膜整体愈合率为98.8%,四组患者术后鼓膜愈合率无显著性差异。四组患者术后气骨导差均较术前有所下降,其差异无统计学意义。结论伴有真菌性外耳道炎的慢性化脓性中耳炎的患者行I型鼓室成形术后鼓膜愈合率未见降低,疗效无明显差异。OBJECTIVE To observe the clinical efficacy of endoscopic type I tympanoplasty in patients with chronic suppurative otitis media accompanied by fungal otitis media.METHODS Based on the symptom characteristics of the external auditory canal and tympanic mucosa,80 patients were divided into four groups:dry ear without fungi group,dry ear with fungi group,wet ear without fungi group,and wet ear with fungi group.Record its clinical characteristics.Patients with fungal otitis externa should receive medication treatment during the perioperative period.Failure to heal the tympanic membrane repaired 6 months after surgery,recurrent perforation of the graft,and/or persistent inability to dry the ear are considered repair failures.RESULTS A total of 80 patients were included in this study,and the overall healing rate of the tympanic membrane in the four groups of patients was 98.8%.There was no significant difference in the postoperative tympanic membrane healing rate among the four groups of patients.The postoperative air bone conduction difference in all four groups of patients decreased compared to preoperative levels,but the difference was not statistically significant.CONCLUSION Patients with chronic suppurative otitis media accompanied by fungal otitis media undergoing type I tympanoplasty showed no decrease in tympanic membrane healing rate and no significant improvement in efficacy.

关 键 词：耳真菌病 耳道 中耳炎 化脓性 鼓室成形术 内窥镜检查 耳内镜检查 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]