耳内镜下中耳及面神经手术135例

目的：探讨耳内镜技术用于中耳显微及面神经手术的方法，对耳内镜下施行中耳显微及面神经手术的优缺点进行评价。方法：临床确诊的中耳疾病和周围性面瘫患者135例（147耳），包括外伤性面瘫13例（定位面神经锥段、水平段、膝状神经节12例，颞骨粉碎性骨折伴内听骨折1例）；慢性化脓脓性中耳炎各型共111例（122耳）；传导性耳袭8例（9耳）；外、中耳先天性畸形1例，先天性岩尖胆脂瘤伴面瘫1例，中耳骨1例，全部手术均在德国ASAP耳内镜系统下操作，结果：外伤性面瘫13例术后随访2－8mo，面肌功能完全恢复者76．9％，面肌以、中度功能异常3例（23．1％），鼓膜修补患者出院时鼓膜完全愈合者95％，遗有裂隙者5％，随访1－8mo，鼓膜遗有穿孔者9％，失访者11例（12耳），听骨链重建术后，平均听力较术前提高30dB，乳突治及改良乳突根治术后平均干耳时间1.5mo，结论：耳内镜技术用于耳显微，耳神经外科手术效果良好。

Endoscope-assisted middle ear and facial nerve surgery: Report of 135 cases

AIM To research the middle ear and facial nerve surgery using endoscopic technique and it's advantage. METHODS 135 patients (147ears) with traumatic facial paralysis ( n =13), chronic suppurative otitis media ( n =111), conductive deafness ( n =8), congenital external and middle ear deformity ( n =1), congenital cholesteatoma in petrous apex ( n =1), osteoma in middle ear ( n =1) underwent surgery using endoscopic technique instead of microscope. All procedures were performed with ASAP otoendoscopic system (made in German). RESULTS Facial muscle function were totally recovered in 10 cases (76.9%) of traumatic facial paralysis while 3 cases (23.1%) still suffered mild to medium facial paralysis after 2~8 mo of following up. 95% of patients who received tympanoplasty type I recovered totally while 5% were still with fissures at the time of discharge and 9% with perforation after 1~8 mo of following up. Hearing level improved at an average of 30 dB in patients with ossicular chain deformity. Patients who received radical mastoidectomy got a dry ear at an average of 1.5 mo. CONCLUSION Otoendoscopy offers advantages to middle ear and otoneurosurgery.