乳突根治术后不干耳原因分析

目的探讨乳突根治术后不干耳原因,提高疗效,提出防治措施,减少复发并发症。方法对2000年～2012年25例患者再次乳突根治术总结分析。结果本组25例患者中,脂瘤残留13例;面神经嵴过高5例;外耳道口狭窄6例;换药不当1例,术后坚持换药1.5个月后干耳。24例再次乳突根治术达到术腔完全上皮化,干耳时间平均在术后1～3个月。结论病灶清除不彻底、术腔引流不畅、术后换药不当等是乳突根治术常见不干耳原因,根据不同原因采取相应措施是预防再次流脓的关键,术后随访3～6个月无再流脓病例发生。

Analysis of reasons for nondryears after radical mastoidectomy

OBJECTIVE To explore the reasons of nondryears after mastoid radical surgery for improvingcurative effect,putting forward prevention measures,and reducing the complications of recurrence. METHODS 25 cases of patients from 2000 to 2012 were analyzed. They all had second mastoidotympanectomy because of nondryears. RESULTS There were 13 cases of cholesteatoma residual,5 cases of high facial nerve ridge,6 cases of external auditory canal stenosis;1 case of improper treatment,of which postoperative change dressing insisted on applying 1.5 months until the ear was dry. The mastoid cavities of 24 cases got complete epithelialization after the second mastoidotympanectomy. The duration of dry ear time was averaged about 1～3 months after surgery. CONCLUSION Incomplete pathological clearance, improper cavity drainage, and incorrect postoperative treatment is the common cause of nondryears after mastoidotympanectomy. According to different reasons, corresponding measure is the key to prevent discharging again. Postoperative follow-up of 3～6 months of these cases revealed no discharging occurred again.