颞骨CT和咽鼓管功能检查对胆脂瘤型中耳炎咽鼓管鼓室口病变的诊断意义

目的：探讨颞骨高分辨率CT（HRCT）和咽鼓管功能检查对胆脂瘤型中耳炎患者术前咽鼓管鼓室口病变的诊断价值。方法：回顾性分析38例（41耳）胆脂瘤型中耳炎患者术前颞骨HRCT扫描和咽鼓管功能综合测试仪检查结果，并与术中显微镜下探查咽鼓管鼓室口处病变情况进行对比分析。结果：颞骨HRCT发现咽鼓管鼓室口软组织占位影34耳；术中发现鼓室口病变32耳，其中为肉芽组织22耳和胆脂瘤4耳，脓团堵塞3耳，鼓室口周围黏膜肥厚肿胀2耳，黏膜粘连闭锁1耳。咽鼓管功能障碍37耳，其中为阻塞型32耳，闭锁不全型5耳。结论：对胆脂瘤型中耳炎患者术前进行颞骨HRCT扫描和咽鼓管功能检查，对术中有目的地处理咽鼓管鼓室口的病变，制定手术方案和预估治疗效果具有重要意义。

The value of computed tomography scans of temporal bone and eustachian tubal function tests for lesions at tympanic opening of eustachian tube in middle ear cholesteatoma

Objective:To investigate the value of high resolution computed tomography (HRCT) of temporal bone and eustachian tubal function tests for lesions at tympanic opening of eustachian tube in the patients of otitis media with cholesteatoma prior to surgery.Method:The clinical data of 38 cases (41 ears) with cholesteatoma, which were examed by HRCT scans and eustachian tubal function tests before mastoidectomy (29 ears) or mastoidectomy tympanoplasty (12ears), were analyzed.Result:The rate of conformation between the radiographic and the operative findings was 94.1% in the tympanic opening of eustachian tube. We found that the rate of the process tissue in the tympanic opening of eustachian tube was 86.5%(32/37) during the operation and that they were mainly granulation tissues and cholesteatoma.The rate of eustachian tubal hypofunction was 90.2%(37/41), the obstructive type and the imcompetent type were 32 ears and five ears, respectively, only four were normal.Conclusion:HRCT scans and eustachian tubal function tests by Sonotubometry and Tubotymanoaerodynamic (TTAG) play vital roles in diagnosis of the tympanic opening lesion of eustachian tube and in assessment of eustachian tubal function pre-operation of middle ear cholesteatoma.