浅谈改良乳突切除保留骨桥鼓室成形术治疗中耳乳突炎的体会

目的探讨改良乳突切除保留骨桥同期行鼓室成形术治疗慢性化脓性中耳乳突炎患者的临床疗效。方法对83例(83耳)慢性化脓性中耳乳突炎患者(含胆脂瘤型、骨疡型)施行改良乳突切除保留骨桥同期行鼓室成形术的治疗过程进行回顾性分析及总结。结果 83例患者术后观察1个月-4年,鼓膜修补愈合率为95.18%,听力改善有效率为68.67%,无效率31.32%,3个月内全部干耳。听力恢复较好者为长期反复流脓、听力渐进性下降、中耳乳突不可逆病理改变的慢性单纯型中耳乳突炎患者,治疗有效率为95.65%,其次为骨疡型,有效率为85.71%,胆脂瘤型最差,有效率为34.37%。结论长期反复流脓、听力渐进下降的慢性化脓性中耳乳突炎患者,应早日行改良乳突切除保留骨桥同期行鼓室成形术,可获得早日干耳,听力提高,防止听力丧失。对胆脂瘤型、骨疡型中耳乳突炎患者,在清除病灶的基础上尽可能保留乳突气房及骨桥同期行鼓室成形术,亦可早日干耳、提高听力。

Experience on the treatment for otitis media and mastoiditis after intact-bridge mastoitympanoplasty(IBM) improvement

Objective To investigate the clinical efficiency of the treatment for chronic otitis mastoidea after intactbridge mastoitympanoplasty(IBM).Methods The charts of 83 ears that suffered chronic otitis media(including patients with cholesteatoma,granulation type),which underwent the treatment of IBM were reviewed.Results 83 cases were observed after 1 months to 4 years,repair of the tympanic membrane healing rate was 95.18%,hearing improvement rate was 68.67%,no efficiency was 31.32%,dry ear within 3 months.Hearing recovery is better for long-term repeated pus hearing progressive decline of middle ear and mastoid irreversible pathological changes simple otitis media patients,efficiency of 95.65%,followed by type of efficiency of 85.71% for the worst,cholesteatoma,efficiency of 34.37%.Conclusion Long-term repeated pus hearing progressive declines in chronic suppurative otitis media patients should soon modified mastoid bone bridge resection retaining undergoing tympanoplasty,can obtain the early dry ear,listening,to prevent hearing loss.On cholesteatoma,carious type otitis media patients,in the removal of the lesion as possible based on the retention of mastoid air cells and the bone bridge simultaneous tympanoplasty,also early dry ear listening.