活动期慢性化脓性中耳炎I期听力重建的研究

目的探讨活动期慢性化脓性中耳炎I期鼓室成形术的可行性和疗效。方法48例活动期（48耳）慢性化脓性中耳炎患者（胆脂瘤型31例，骨疡型17例）在彻底清除病变（经典或改良乳突根治术）同时进行Wullstein Ⅱ型和Ⅲ型鼓室成形术。结果全部4～10周，平均7周干耳。术后1年纯音听力测试：气骨导差10dB以内者11例，15～20dB者25例，25～30dB者9例，无变化甚至更差者3例。结论慢性化脓性中耳炎活动期不是鼓室成形术的绝对禁忌证。术中彻底清除所有病变、重建乳突-鼓室-咽鼓管引流通气系统后，进行WullsteinⅢ型＋乳突腔填充＋耳甲腔成形术是可取的方法，同时咽鼓管是否通畅是手术成败的主要原因。

Study of simultaneous audition reconstruction to chronic suppurative otitis media in the period of infection

Objective To investigate the possibility and surgical effect of simultaneous tympanoplasty to chronic suppurative otitis media in the period of infection. Methods Forty-eight cases（48 ears） with chronic suppurative otitis media in the period of infection （31 with cholesteatoma, 17 with caries） were underwent simultaneous Wullstein Ⅱ and Ⅲ tympanoplasty on the complete ehmination of the lesions （typical or modified mastoidectomy）. Results All cases had dry ears within 4-10 weeks with average of 7 weeks. The air-bone gap within 10 dB was in 11 cases, 15 to 20 dB in 25 cases, 25 to 30 dB in 9 cases, no change or worse in 3 cases. Conclusions Infection is not the absolute contraindication to the tympanoplasty in treating chronic suppurative otitis media, Wullstein Ⅲ tympanoplasty plus mastoid cavity obliteration and conchaplasty is a suitable choice to treating chronic suppurative otitis media on the complete elimination of lesions and reconstruction of the ventilation system among mastoid cavity, tympanum and eustachian. The malfunction of eustachian is the main cause to failure of surgery.