保留或重建部分外耳道后骨壁的乳突根治鼓室成形术

目的 :探讨乳突根治鼓室成形术中保留或重建部分外耳道后骨壁对提高胆脂瘤型中耳炎术后患者的干耳率及听力水平的意义。方法 :保留部分外耳道后壁 2 4例、2 5耳 ,重建外耳道部分后壁 6例、6耳 ,均行I期鼓室成形术。结果 :术后随访 11个月～ 4年 ,术后干耳并提高听力达实用听力 (2 5dB以上 ) 2 3耳 ,治愈率82 .1%;复发 4耳 ,复发率 12 .9%。结论 :在乳突根治鼓室成形术中保留或重建部分外耳道后骨壁有利于增加中耳含气腔 ,提高听力 ;且有利于术后观察乳突腔病变 ,避免胆脂瘤复发 ,提高干耳率。

Study on retaining or reconstruction partial posterior wall of osseous external acoustic meatus in mastoidectomy and tympanoplasty

Objective:To retain or reconstruct partial posterior wall of osseous external acoustic meatus (PPWOEAM)during the operation of mastoidectomy and tympanoplasty in order to raise the rate of dry ear and hearing of patients with cholesteatoma of otitis media.Method:24 patients (25 ears )had undergone operation of retaining PPWOEAM and 6 patients (6 ears) were performed operation to reconstruct PPWOEAM.All of them had tympanoplasty of I period.Result:30 patients were followed up from 11 to 48 months,23 ears got dry ear and increased their hearing to normal,the cure rate was 82.1%.4 ears recurred,and the rate was 12.9%.Conclusion:The operations which retain or reconstruct PPWOEAM during the mastoidectomy and tympanoplasty,can not only increase pnenmatic space of mastoid process and hearing,but also observe disease of mastoid process and avoid recurrence of cholesteatoma.