开放式鼓室成形术治疗胆脂瘤型中耳炎疗效观察

目的探讨开放式鼓室成形术治疗胆脂瘤型中耳炎的临床效果和影响预后的因素.方法对胆脂瘤型中耳炎116例行开放式鼓室成形术,并对手术方法进行分析.结果经1-5年随访,颞肌筋膜完全成活109例,6例再穿孔,1例复发流脓,患者均有短且大的外耳道,术腔上皮化、干耳.术后9个月听力提高10dB56例、15-20dB34例,25-30dB6例,20例无变化.结论施行开放式鼓室成形术,只要彻底清除乳突、中耳病变,恢复中耳通气功能,可以消除炎症,防止胆脂瘤复发和提高听力.

Cholesteatoma surgery:open tympanoplasty

Objective To study the curative effect and the factors affecting the prognosis in patients with choleateatoma of the middle ear and the mastoid after open tympnoplasty. Methods 116 patients affected by chronic otitis media with cholesteatoma underwent open tympanoplasty from 1990~2002 years, follow-up period ranged from 1 to 5 years. Results Tympanic membrane perforation closure was accomplished in 109 cases. Perforation occurred in 6 cases postoperatively. Cholesteatoma recurred in 1 case. Dry ear rate was 99.13%. The postoperative hearing threshold level improved over 10 dBHL (air conducted threshold) in 96 ears (82.76%) . Conclusionos The open tympanoplasty had advantage in retaining physical structure of middle ear and complete removal of lesions. The keys of this procedure are contouring the mastoid cavity , thorough removal of lesions and restoring the Eustachian tube funtion.