自体移植外耳道后壁重建联合鼓室成形术用于老年中耳胆脂瘤患者治疗的疗效及安全性分析

目的采用自体移植外耳道后壁重建联合鼓室成形术用于老年中耳胆脂瘤患者治疗疗效及其对安全性进行研究。方法选取2016年9月至2018年9月在惠州市第六人民医院手术治疗的80例老年中耳胆脂瘤患者,采用随机数字表法分为观察组41例和对照组39例。对照组采用经典完壁式乳突切除术鼓室成形术治疗,观察组采取自体移植外耳道后壁重建联合鼓室成形术治疗。比较两组治疗疗效、安全性及术后恢复情况。结果①观察组治疗后临床疗效高于对照组(95.12%vs.84.62%)(P<0.05)。②两组治疗后并发症发生率比较,差异无统计学意义(P>0.05)。③观察组术后骨膜I期愈合率高于对照组,而耳膜穿孔率低于对照组(P<0.05)。两组术后外耳道后壁重建成功率比较,差异无统计学意义(P>0.05)。结论自体移植外耳道后壁重建联合鼓室成形术在老年中耳胆脂瘤患者的治疗中具有疗效显著、安全性高、术后恢复佳等优势,具有临床推广应用价值。

Efficacy and safety of autologous posterior wall reconstruction of external auditory canal combined with tympanoplasty in treatment of middle ear cholesteatoma in elderly patients

【Objective】To study the efficacy and safety of autotransplantation of posterior wall reconstruction of external auditory canal combined with tympanoplasty in the treatment of middle ear cholesteatoma in elderly patients,and to provide support for its clinical application and promotion.【Methods】Eighty elderly patients with middle ear cholesteatoma who underwent surgery in Huizhou Sixth People's Hospital from September 2016 to September 2018 were selected as the study subjects.They were divided into observation group and control group according to random number table method.According to the grouping,the patients were treated with autologous transplantation of posterior wall of external auditory canal reconstruction combined with tympanoplasty and classical complete mastoidectomy combined with tympanoplasty.Statistical evaluation and inter-group comparison of efficacy,safety and post-operative data were performed for each unit.【Results】The total effective rates of the two groups were 95.12%and 84.62%,respectively,and the difference was statistically significant(P<0.05).The incidences of complications of the observation group and the control group were 14.63%and 15.38%,respectively,and there was no significant difference between the two groups(P>0.05).The first-stage periosteal healing rate was higher,while the rate of eardrum perforation was lower in the observation group than in the control group(P<0.05).The success rate of reconstruction of posterior wall of external auditory canal was 90.24%and 89.74%in the observation group and the control group,which had no significant difference(P>0.05).【Conclusion】Autologous transplantation of posterior wall reconstruction of external auditory canal combined with tympanoplasty in the treatment of elderly patients with middle ear cholesteatoma has obvious curative effect,high safety,good data after operation and other advantages,and has clinical popularization value.