保留低位骨桥的开放式乳突根治并鼓室成形术65例临床分析

目的 回顾性分析近期本人施行的65例保留低位骨桥的开放式乳突根治鼓室成型手术。方法 回顾分析2003年1月-2004年3月本人实施的65例保留低位骨桥的开放式乳突根治鼓室成型手术病例，其中胆脂瘤型中耳炎41例．骨疡型中耳炎24例介绍其手术方法并对术后干耳率及听力提高情况进行了统计分析。结果所 有病人均获干耳．鼓膜愈合良好，无明显内陷。干耳时间约为1—3个月，术后随访1年，无一例胆脂瘤或中耳炎复发。干耳后的听力恢复较满意。平均气骨导差缩小在10dB以上共占83．6％，其中10—20dB占38．2％，20—30dB占30．5％，〉30dB者14．9％。结论 保留低位骨桥的开放式乳突根治术在治疗胆脂瘤型或严重骨疡型中耳炎中既能保证彻底清除病变又能最大限度提高患耳的听力．是治疗这类疾病一种较好的手术方法。

Intact bridge mastoidectomy with tympanoplasty in treating cholesteatoma and chronic otitis media: 65 cases report

Objective To evaluate the effects of the operation of intact-bridge mastoidectomy with tympanoplasty in treating cholesteatoma and chronic otitis media with osteitis. Methods A retrospective review was performed of 65 cases undergoing an intact-bridge mastoidectomy with tympanoplasty by the first author during the time interval from January 2003 to March 2004. Of the 65 casas,41 cases were diagnosed as cholesteatoma after operation,and 24 cases,chronic otitis media with osteitis. Results The outcome of dry and well-epithelialized mastoid cavities in was achiered about 1-3 months and all perforations had closed. After 1-year follow-up no recurrence occurred. Hearing improvement of greater than 10 dB was achieved in 83.6% of the cases(10-20 dB in 38.2%,21-30 dB in 30.5%,and above 30 dB in 14.9%. Conclusion This procedure is a optimal cure strategy for cholesteatoma and severe chronic otitis media,which can not only remove the pathological changes thoroughly to prevent disease recurrence but also maximatily improve the hearing of the diseased ear.