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上鼓室胆脂瘤手术治疗
引用本文:蒋立新,马玉坤,杨宁,罗冬,刘秀虹,蔡琴芳,涂博. 上鼓室胆脂瘤手术治疗[J]. 中国耳鼻咽喉头颈外科, 2010, 17(3): 131-132,139
作者姓名:蒋立新  马玉坤  杨宁  罗冬  刘秀虹  蔡琴芳  涂博
作者单位:暨南大学附属第一医院耳鼻咽喉头颈外科,广东,广州,510630;暨南大学附属第一医院耳鼻咽喉头颈外科,广东,广州,510630;暨南大学附属第一医院耳鼻咽喉头颈外科,广东,广州,510630;暨南大学附属第一医院耳鼻咽喉头颈外科,广东,广州,510630;暨南大学附属第一医院耳鼻咽喉头颈外科,广东,广州,510630;暨南大学附属第一医院耳鼻咽喉头颈外科,广东,广州,510630;暨南大学附属第一医院耳鼻咽喉头颈外科,广东,广州,510630
基金项目:广东省医学科研基金资助项目(A2007335)
摘    要:目的评估保留完整外耳道后上壁的上鼓室开放术治疗局限性胆脂瘤的临床疗效。方法38耳上鼓室胆脂瘤及内陷袋形成患者,耳内镜检查鼓膜松弛部内陷9耳,鼓膜松弛部穿孔27耳,外耳道胆脂瘤侵入上鼓室2耳。颞骨轴位和冠状位CT检查,病变局限在上鼓室区,天盖无明显破坏或下垂。虚拟耳镜显示听骨链完整13耳,听骨链变形12耳,听小骨不同程度破坏13耳。手术时在颞线下磨开外耳道后上嵴至颧弓后根骨壁,保留菲薄完整的外耳道后上壁和天盖,开放上鼓室经上而下处理胆脂瘤及鳞状上皮,完成听骨链成形术。结果术后外耳道完整,鼓膜松弛部穿孔或内陷袋行鼓膜修补术均一期愈合,术后平均听力较术前平均提高15~25dBHL,随访1.0~4.0年未见胆脂瘤复发。结论保留完整外耳道壁的上鼓室开放技术,在彻底清除上鼓室和听骨链病变的同时,完整保持外耳道和鼓室结构,临床疗效满意。

关 键 词:中耳炎  胆脂瘤  中耳  鼓室成形术

Efficacy of the attic open technique with intact canal wall in treating localized cholesteatoma
JIANG Lixin,MA Yukun,YANG Ning,LUO Dong,LIU Xiuhong,CAI Qinfang,TU Bo. Efficacy of the attic open technique with intact canal wall in treating localized cholesteatoma[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2010, 17(3): 131-132,139
Authors:JIANG Lixin  MA Yukun  YANG Ning  LUO Dong  LIU Xiuhong  CAI Qinfang  TU Bo
Affiliation:Department of Otolaryngology Head and Neck Surgery;the First Affiliated Hospital of Jinan University;Guangzhou;Guangdong;510630;China
Abstract:OBJECTIVE To evaluate the clinical efficacy of the attic open technique with intact canal wall in treating localized cholesteatoma.METHODS In 38 ears with attic cholesteatoma,retraction of flaccid part were found in 9 ears,flaccid part perforation in 27 ears,external auditory canal cholesteatoma in 2 ears by ear endoscopy.Temporal bone axial and coronal CT were carried out in all of the patients .localized lesions were found in the attic,without tegmen tympani destruction or ptosis.Virtual CT endoscopy show...
Keywords:Otitis Media  Cholesteatoma  Middle Ear  Tympanoplasty  
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