粘连性中耳炎的药物及手术治疗的临床观察

目的：探讨治疗粘连性中耳炎的药物及手术治疗的疗效。方法：对19例（19耳）粘连性中耳炎患者进行了药物治疗,21例（21耳）粘连性中耳炎患者进行了手术治疗。药物治疗组用波氏球法吹张患耳咽鼓管,鼓室内注射1%糜蛋白酶及地塞米松混合液,鼓室注射后再行患耳波氏球法咽鼓管吹张术。手术组术中切除粘连的鼓膜以及瘢痕组织,进行听骨链重建,并用耳屏软骨修补鼓膜穿孔。结果：药物组治疗1个月后听力提高10dB以上者占63.2%（13/19）;手术组术后1个月听力提高10dB以上者占66.7%（14/21）。结论：粘连性中耳炎可以进行药物及手术治疗,咽鼓管的处理非常重要。

Clinical Observation of Pharmacotherapy and Surgical Therapy of Adhesive Otitis Media

Objective：To investigate the therapeutic effect of pharmacotherapy and surgical treatment of adhesive otitis media.Methods：17 patients（17 ears） with adhesive otitis media accept pharmacotherapy,21 patients（21ears） with adhesive otitis media accept surgical procedures.In the pharmacotherapy group,patients accept eustachian tube Bordetella ball insufflation before and after tympanic injection of 1% of the chymotrypsin and dexamethasone mixture.In the surgical therapy group,we remove the adhesive tympanic membrane as well as scar tissue adhesions,then we reconstruct ossicular chain,and use the tragus cartilage for tympanic membrane perforation repair.Results： In the pharmacotherapy group,after 1 month,the patients whose hearing level increased more than 10dB account for 63.2%（13/19）;In the surgical therapy group,after 1 month,the patients whose hearing level increased more than 10dB account for 66.7%（14/21）.Conclusion：Adhesive otitis media can be treated by pharmacotherapy and surgical therapy,treatment of the eustachian tube is very important.