开放式鼓室成形术治疗胆脂瘤型中耳炎21例临床观察

目的：探讨开放式鼓室成形术治疗胆脂瘤型中耳炎的疗效,为临床治疗提供依据。方法：随机选取2009年1月至2012年1月在我院应用开放式鼓室成形术（乳突根治伴鼓室成形术）治疗胆脂瘤型中耳炎的患者21例,对其临床资料以及手术方式进行回顾性分析。结果：治疗后,本组21例患者中18例移植筋膜完全成活,2例发生鼓膜再穿孔,1例鼓膜内陷、复发流脓,所有患者全部干耳。术后对患者听力进行纯音测试,其中10例听力提高10dB,7例听力提高15-20dB,1例听力提高25-30dB,3例听力未见变化。结论：对胆脂瘤型中耳炎患者行开放式鼓室成形术,在对中耳病变、乳突进行彻底清除的前提下,可使中耳内的炎症得到消除、通气功能得到恢复,从而起到根治的效果。因此,开放式鼓室成形术不仅能有效防止胆脂瘤的复发,还能显著提高患者听力,具有较高的应用价值,值得临床推广运用。

Clinical Observation on 21 Cases Cholesteatoma Otitis Media Treated with Open Method Tympanoplasty

Objective： To observe the application of open method tympanoplasty to treat cholesteatoma otitis media for providing basis for clinical treatment.Method： 21 patients with cholesteatoma otitis media treated with open method tympanoplasty in our hospital from Jan.2009 to Jan.2012 were selected randomly,and the clinical data and operation mode were analyzed retrospectively.Result：After the treatment,there were 18 patients of shift planting membrane surviving completely among 21 cases,2 patients occurring tympanic membrane perforation,1 case of tympanic membrane invagination and recurrence of pus,all the patients dried ears.Patients were given pure tone test after operation,there were 10 cases of hearing improvement of 10dB,7 cases of hearing improvement of 15-20dB,1 case of hearing improvement of 25-30dB and 3 cases of hearing no change.Conclusion：In the premise of complete removal of middle ear diseases and mastoid,open method tympanoplasty in treating the patients with cholesteatoma otitis media can eliminate the middle ear inflammation and make the ventilation function recovered,which has the curative effect.Therefore,open method tympanoplasty not only can prevent the recurrence of cholesteatoma effectively but also can improve the listening comprehension of patients significantly,which has higher application value and is worthy of clinical application.