中耳术后的临床CT分析

目的 探讨中耳术后CT检查的价值和手术效果.资料与方法 中耳术后21耳进行了CT检查,将其手术类型、临床听力和CT表现进行比较分析.结果 术后患者主观听力与术前相似者7耳,其中1耳为单纯病灶清除,1耳为人工金属镫骨脱出于外耳道,1耳为同种异体听骨链重建,乳突根治术后听骨链消失和部分听小骨残留各2耳.术后听力明显提高9耳,其中同种异体听骨链重建5耳,自体听骨链重建4耳.术后听力提高后又突然下降3耳,其中1耳为重建听小骨与鼓膜分开,1耳为重建听小骨与卵圆窗分开,1耳为锤镫关节脱位,再次手术后听力均明显提高.2耳因胆脂瘤术后面瘫,CT示面神经管鼓室段缺损,再次手术后面瘫症状逐渐消失,但听力与术前相似.结论 术后CT检查可明确中耳手术效果,听骨链重建手术有助于提高听力.

CT Analysis of Postoperation on the Middle Ear

Objective To investigate CT value of postoperation on the middle ear and the effect of surgery. Materials and Methods CT findings, type of surgery and the effect of clinic auditory acuity of 21 ears after operation were analyzed and compared. Results The acoustic sensibility after post-operation was similar to pre-operation in 7 ears, pure focus clearances in 1 ear, the artificial metal stapes was taken out of auditory canal in 1 ear, the homologous variant ossicular chain reconstructed in 1 ear, the whole or partial disappearance of ossicular chain in individually 2 ears after mastoidotympanectomy. The auditory acuity after post-operation was obviously improved in 9 ears, of which the reconstruction with homologous variant ossicular chain in 5 ears and autogeneic ossicles in 4 ears. The acoustic sensibility was elevated and the descended abruptly in 3 ears after operation, the drum membrane separated with ossicles in 1 ear, the ossicle detached from oval window in 1 ear, the dislocation of malleus and stirrup in 1 ear. The aeouesthesia was striking raised after operation again in the 3 cases. Facial paralysis was took placed in 2 ears after exsection of cholesteatoma,the defect of canal for facial nerve in tympanic segment was found on CT, after operation again the symptoms of facial paralysis were gradually vanished, but the auditory acuity was similar to pre-operation. Conclusion The effect of operation on middle ear can be identified by CT examination, and the reconstruction of ossicles can improve acoustic sensibility.