耳道径路全内镜下中耳胆脂瘤切除术可行性分析

目的探讨耳道径路全内镜下中耳胆脂瘤切除术的临床疗效及可行性。方法回顾江门中心医院2014年7月～2018年8月采用耳道径路全内镜下切除的30例中耳胆脂瘤患者的临床资料。30例患者中19例胆脂瘤局限于中耳鼓室腔，未超越鼓窦入口；11例患者胆脂瘤超越鼓窦入口，侵及鼓窦但未累及乳突腔。结果30例患者术后鼓膜均一期愈合，无一例出现严重感音神经性耳聋、面瘫、眩晕及脑膜炎等并发症。术后患耳听力改善者27例，听力无改善者3例；术后1个月内干耳者25例，1~2个月干耳者5例。随访至今，所有患者均未出现胆脂瘤复发，无二次手术者。结论耳道径路全内镜下中耳胆脂瘤切除术是一种安全有效的手术方法。该术式具有视野广阔清晰、操作简单、美容、术中出血少、创伤小、并发症少及术后恢复快优点，值得临床推广。

Feasibility analysis of middle ear cholesteatomectomy via total endoscopic transear approach

ObjectiveTo investigate the clinical efficacy and feasibility of middle ear cholesteatomectomy via total endoscopic transear approach.MethodsThe clinical data of the above cholesteatomectomy were retrospectively analyzed for 30 cases, who were admitted to Central Hospital of Jiangmen City from July 2014 to August 2018. 19 cases of them were confined to the middle ear tympanic cavity and did not exceed the entrance of the sinus; 19 cases of 30 patients had cholesteatoma beyond the entrance of the sinus, invading the sinus but not involving the mastoid cavity.ResultsAfter operation, the tympanic membrane was healed by first intention in all the 30 patients. None of the 30 patients had severe sensorineural deafness, facial paralysis, vertigo and meningitis. 27 cases of 30 patients were improved hearing, but 3 cases were not improved hearing after operation. 25 cases of 30 patients had dry ears after operation in one month, and 5 cases of 30 patients had dry ears after operation during 1 monts to 2 months. Follow up to date, no recurrence of cholesteatoma occurred in all patients, and no second operation was performed.ConclusionThe middle ear cholesteatomectomy via total endoscopic transear approach is a safe and effective surgical procedure. This operation has the advantages of broad and clear vision, simple operation, cosmetology, less intraoperative bleeding, less trauma, fewer complications and quick recovery after surgery, and is worthy of clinical promotion.