慢性化脓性中耳炎手术远期疗效分析

目的:探讨慢性化脓性中耳乳突炎手术适应证并分析其治疗的远期疗效。方法:回顾性分析1995～1998年经5年以上随访的130例(145耳)乳突根治术病例,对比分析了开放式乳突根治术(RM),完壁式乳突根治术(CWUM)与开放式乳突根治术伴乳突填塞术(CWDM)的优、缺点及远期疗效。结果:RM术后听力变化不大,CWUM与CWDM远期听力分别较术前听力气导提高(10.84±4.63)dBHL和(10.39±3.93)dBHL;从远期复发率看,RM为11.63%,CWUM为22.58%,CWDM为12.68%;就复诊率而言,RM患者复诊率较高。结论:RM、CWUM与CWDM各具优点,术前必须仔细选择适应证;从远期效果看CWDM优于RM和CWUM。

Long-term results analysis of mastoidectomy for chronic otitis media

OBJECTIVE: To study the operative indications of chronic otitis media and their long-term results. METHOD: One hundred and forty-five cases of mastoidectomy were followed for 5 years between 1995-1998. We discussed the results of recurrence and hearing level of radical mastoidectomy, canal wall up mastoidectomy (CWUM) and canal wall down mastoidectomy with mastoid obliteration (CWDM). Advantages and disadvantages were analyzed by the rate of visiting. RESULT: RM is almost invariable in hearing. There is no significant difference between CWDM [improved (10.84+/-4.63) dB HL] and CWUM [improved (10.39+/-3.93) dB HL]. The recurrence rate of RM was 11.63%, CWDM was 12.68%, but the CWUM was 22.58%. Rate of re-visiting of RM is obviously higher that of CWUM and CWDM. CONCLUSION: RM, CWUM and CWDM have all advantages, but the indication must be selected carefully. The effect of CWDM is better than that of RM and CWUM for the long-term results in these cases.