保留乳突的改良完壁式鼓室成形术的临床疗效观察

目的 探讨局限于上鼓室区病变的慢性化脓性中耳炎、中耳胆脂瘤行上鼓室径路保留乳突的改良完壁式鼓室成形术的长期临床疗效.方法 诊断慢性化脓性中耳炎、中耳胆脂瘤47例(47耳)患者,结合患者专科检查,依据手术方式不同分A、B两组,A组行上鼓室径路保留乳突的改良完壁式鼓室成形术,B组行完壁式乳突切开+鼓室成形术.术后随访5～7...

Long-term Clinical Outcomes of Modified Intact CanalWall Tympanoplasty with Preservation of Mastoid Process

Objective To report long-term clinical outcomes of modified intact canal wall tympanoplasty with preservation of mastoid process via a localized attic approach in patients with chronic suppurative otitis media and local middle ear cholesteatoma confined to the attic.Methods Forty-seven patients(47 ears)diagnosed with chronic suppurative otitis media and middle ear cholesteatoma by specialist examination received either modified intact canal wall tympanoplasty with preservation of mastoid process via a localized attic approach(group A)or intact canal wall tympanoplasty with mastoidectomy(group B)and followed up for 5-7 years.Pre-and postoperative air conduction(AC)and bone conductance(BC)pure tone thresholds and air-bone gap(ABG)were compared.Postoperative hearing improvement,surgery success rate,lesion recurrence and time to dry ear were analyzed.Results Postoperative auditory thresholds improved in both groups.In group A,AC thresholds improved by≥30 dB in 5 cases(16.7%),by 20-30 dB in 11 cases(36.7%),by 10-19 dB in 10 cases(33.3%)and by<10 dB in 4 cases(13.3%),with ABG less than 20 dB in 28 cases(93.3%).No tympanic membrane perforation or retraction and no lesion recurrence were observed in either group.Time to dry ear was shorter in group A(2-4 weeks)than in group B(4-7 weeks).Conclusion The modified intact canal wall tympanoplasty with preservation of mastoid process via a localized attic approach can yield satisfactory outcomes in patients with chronic suppurative otitis media and local middle ear cholesteatoma confined to the attic.