鼓室完壁开放技术鼓室成形术的临床应用

目的评价鼓室完壁开放技术鼓室成形术治疗慢性中耳乳突炎的疗效.方法2001年1月至2002年12月我院收治35例37耳慢性中耳乳突炎,经术前全身、局部抗感染治疗后,行鼓室完壁开放技术鼓室成形术（保留桥）.手术要求保留鼓室壁完整,重建或保留听骨链,修复上鼓室外侧壁,行乳突肌骨膜瓣填塞、耳甲腔成形、蝶形术腔软组织内陷等;并对干耳时间及术前、术后听力进行观察.结果37耳的干耳时间为1～3个月,平均1.5个月.37耳上鼓室外侧壁形态良好,听骨链保留28耳、重建9耳.听力以0.5、1.0、2.0 kHz（听力级）3个语言频率气导及气骨导差缩小的平均值评定.术后平均气骨导差为15.27 dB,较术前的34.95 dB明显缩小（P＜0.01）.结论鼓室完壁开放技术鼓室成型术治疗慢性中耳乳突炎能保证清除病灶,并保留或重建听骨链,重建上鼓室外侧壁;且可恢复中耳解剖腔隙结构;患者听力提高较满意.

Intact wall open technic tympanoplasty in chronic otitis media

Objective To appraise the effect of intact wall open technic tympanoplasty on chronic otitis media. Methods 37 cases with chronic otitis media undergoing intact wall open technic tympanoplasty were analysed in our department from 2001 to 2002. Results The operations in all cases were successful.The average air-bone difference(0.5,1.0,2.0 Hz hearing loss) was 34.95 dB before operation and 15.27 dB after operations(P<0.01), the difference was statistically significant. Conclusion The intact wall open-technic tympanoplasty is suitable for chronic suppurative otitis media and mastoiditis(limited cholesteatoma,granulation and tympanosclerosis) with clearance of lesions;retaining or reconstructing ossicular chain,lateral wall of upper tympanic cavity and recovering the interspace structure of the middle ear and thus providing a rather high satisfactory auditory ability.