联合进路鼓室成形术治疗慢性化脓性中耳炎42例疗效分析

目的观察联合进路鼓室成形术治疗慢性化脓性中耳炎手术疗效。方法应用联合进路鼓室成形术治疗慢性化脓性中耳炎４２例共４８耳，其中Ⅰ期手术者２４例２８耳，分期手术者１８例２０耳，术后随访３—５年。结果Ⅰ期及分期手术后鼓膜愈合率分别为７５％和９０％，胆脂瘤复发率为２１４３％及５％，语言频率（０５、１、２ｋＨｚ）纯音听阈均值气骨导差小于２０ｄＢＨＬ者分别为１３耳（４６４３％）和１５耳（７５％），其中儿童患者分期手术术后胆脂瘤无一例复发。结论联合进路鼓室成形术分期手术治疗慢行化脓性中耳炎远期效果显著，儿童患者行该术时以分期手术为宜。     

Bioreactions at the tissue/hydroxyapatite interface

The events at the hydroxyapatite implant material/tissue interface in the rat middle ear were studied by light microscopy, autoradiography, morphometry, transmission electron microscopy (TEM), scanning electron microscopy (SEM), and X-ray microanalysis. Deposition of calcium, partially in the form of calcium phosphate, was found at the interface. Resorption of the implant material occurred as the result of mono- and multinuclear phagocyte activity. Resorption decreased 6 mnth after the operation, possibly due to the decreasing number of phagocytes at the interface and the increasing amount of bone in the macropores.     

耳内镜下嵌入蝶形软骨鼓膜成形术治疗鼓膜前缘穿孔效果及对患者听力恢复的影响

目的 研究耳内镜下嵌入蝶形软骨鼓膜成形术治疗鼓膜前缘穿孔效果及对患者听力恢复的影响.方法 回顾性分析2017年11月至2019年11月宣城市人民医院进行鼓膜前缘穿孔治疗的100例患者资料,依据患者的治疗方式不同,将其分为观察组与对照组,每组各50例.观察组行耳内镜下嵌入蝶形软骨鼓膜成形术,对照组行显微镜下颞肌筋膜修补术...     

完壁式乳突根治并鼓室成形术治疗慢性化脓性中耳炎的临床有效性分析

目的 分析完璧式乳突根治并鼓室成形术治疗慢性化脓性中耳炎的临床有效性.方法 前瞻性选取丹东市中心医院2018年1月至2019年6月接收的120例慢性化脓性中耳炎患者作为观察对象,按随机数字表法分为2组,对照组60例,采用开放式鼓室成形术;观察组60例,采用完璧式乳突根治并鼓室成形术.观察并记录2组临床疗效,术前、术后1...     

完桥式鼓室成形术治疗慢性化脓性中耳乳突炎的疗效分析

目的评价完桥式鼓室成形术在治疗慢性化脓性中耳乳突炎方面的疗效。方法选择2010年8月至2011年1月来我院耳鼻喉科治疗的50例慢性化脓性中耳乳突炎的患者作为本次临床观察的研究对象,对所选取的患者行完桥式鼓室成形手术,观察手术结果,对所有患者进行6个月的随访,观察术后恢复情况。结果入选患者的干耳时间为3～6周,手术成功的患者为40例,手术成功率为80%,术后患者的听力与术前比较,显著提高,具有统计学意义(P<0.05)。结论完桥式鼓室成形术可以有效地治疗慢性化脓性中耳乳突炎,显著提高患者的听力,值得临床推广使用。     

Tos改良联合进路钛听骨植入鼓室成形的疗效观察*

目的观察符合条件的慢性化脓性中耳炎患者行Tos改良联合入路清理病变并一期植入钛人工听骨行鼓室成形的效果。方法回顾性分析34例在该院施行Tos改良联合入路乳突开放并植入钛人工听骨行鼓室成形的慢性化脓性中耳炎病例,总结患者手术前后听力及影像学特点,观察手术前后言语频率气导听阈变化。结果以术中听骨破坏情况分组,镫骨板上结构缺失组植入全听骨赝复体(TORP)后听力改善(36.25±6.12)dB HL;砧蹬关节中段组植入部分听骨赝复体(PORP)后听力改善(13.18±3.37)dB HL。术后无钛听骨移位、感染,听力改善有效率97.06%(P0.05)。1~3个月全部干耳。结论 Tos改良联合入路鼓室成形并一期植入钛人工听骨能有效地清理中耳病变,尤其是清理后鼓室的隐匿病变,并有效提高听力,术前高分辨率CT(HRCT)发现乳突气化不良,尤其有乙状窦前移、脑板低位和面神经低位等不利于暴露的解剖变异时,可优先选择此术式。     

The effect of inlay butterfly cartilage tympanoplasty technique on compliance

Conclusion: IBCT technique should be preferred owing to its high graft survival rate and ABG gain. While no significant difference was found in middle ear pressures between ears that underwent IBCT and normal ears, compliance values were found to be decreased in patients undergoing IBCT. However, the lack of correlation between ABG gain and compliance values indicated that compliance increase had no effect on post-operative ABG results. Objective: The aim of the present study was to compare tympanometric and audiological parameters in patients undergoing inlay butterfly cartilage tympanoplasty (IBCT) with their normal ears and to determine their difference with normal ear tympanometric parameters. Methods: Overall, 25 patients that underwent an operation between August 2010–May 2014 were included in the present study. In 13 of these patients, the ear that did not undergo operation was normal. 0.5, 1, 2, 4?kHz pure sound average values, tympanometric measurements and compliance values of normal and operated ears were compared. Results: The graft survival rate in patients was found to be 92%. Mean pre-operative air–bone gap (ABG) was 16.4?±?5.4 in patients, while mean post-operative ABG was 10.9?±?5.8, with a statistically significant difference (p?=?0.001) While there was no significant difference between operated and normal ears of patients in terms of middle ear pressure (0.441), compliance values were significantly higher in normal ears than those in operated ears (0.032). When post-operative ABG gain was compared with compliance values, no significant correlation was found between ABG gain and compliance measurements (r?=??0.025 and p?=?0.936).     

慢性化脓性中耳炎手术疗效及相关因素探讨

目的 探讨开放式鼓室成形术(CWdT)和乳突根治术治疗慢性化脓性中耳炎(CSOM)的手术疗效及相关因素.方法 总结2000年3月至2006年1月CSOM手术51例(耳),其中CWdT 13例(耳),乳突根治术38例(耳),并对2种手术方法和预后进行分析比较.结果 术后随访6月后,CWdT组均干耳,无复发,鼓膜穿孔愈合率100%,术后0.5、1.0、2.0 KHz(语言频率)气导纯音听阀均值(PTA)获得保存(PTA变化-4～5 dBHL)和提高(≥6 dBHL)者占84.6%.乳突根治术组38例患者中术后复发或再手术20例,复发率52.6%,术后气导PTA保存和提高者占23.7%.结论 CWdT和乳突根治术治疗CSOM,前者基本无复发,并可根据病变的类型和程度选择术式,绝大多数患者术后可保存或提高听力,一般病变愈单纯,术后听力改善愈佳;后者复发率高,需再手术者不在少数,仅少数患者术后可保存或提高听力.二者比较,差异显著.