保留听骨链的低位完桥鼓室成形术

发布时间：2018-05-22 10:00

本文选题：慢性中耳炎 + 开放式鼓室成形术　；参考：《听力学及言语疾病杂志》2017年03期

【摘要】：目的探讨保留听骨链的完桥式鼓室成形术对上鼓室有阻塞性病变的慢性化脓性中耳炎的效果。方法对23例上鼓室肉芽包裹听骨链阻塞鼓窦入口、影响上鼓室引流的慢性化脓性中耳炎患者采用低位完桥鼓室成形术(鼓窦入口及上鼓室外侧壁保留更加狭窄的低位"骨桥"样结构),彻底清除病变组织,松解活动受限的听骨链,疏通中、上鼓室的引流,术后随访0.5~3年,观察疗效。结果 23例患者术前平均纯音听阈(0.5~2kHz)为43.91±9.90dB HL,气骨导差为24.04±5.10dB,术后随访期内平均纯音听阈稳定,为33.17±7.63dB HL,气骨导差为14.70±4.52dB;所有患者3月内获得干耳;无复发或再次鼓膜穿孔病例;1例术后6月后出现鼓室积液(分泌性中耳炎),行鼓膜置管(T型管),6个月后拔管,随访1年,未再复发。结论对上鼓室有阻塞性病变的慢性化脓性中耳炎患者进行保留听骨链的低位完桥鼓室成形术,复发率低,提高听力效果好。
[Abstract]:Objective to investigate the effect of bridge tympanoplasty with ossicular chain preservation on chronic suppurative otitis media with obstructive lesions in the upper tympanic cavity. Methods 23 cases of superior tympanic granulation covered with ossicular chain blocked the entrance of tympanic sinus. The patients with chronic suppurative otitis media who affected the upper tympanic cavity drainage were treated with tympanoplasty at the end of the bridge (retaining the narrower "bone bridge" structure at the entrance of the tympanic sinus and the lateral wall of the upper tympanic cavity, so as to thoroughly remove the diseased tissue. The ossicular chain with limited activity was loosened, the drainage of the middle and upper tympanic chamber was dredged, and the postoperative follow-up was 0.5 ~ 3 years to observe the curative effect. Results the mean preoperative pure tone hearing threshold was 43.91 卤9.90dB HLand the air-bone conduction difference was 24.04 卤5.10dB. the mean pure tone hearing threshold was stable at 33.17 卤7.63dB HLand the air-bone conductance was 14.70 卤4.52 dB during the follow-up period. There was no recurrence or recurrent perforation of tympanic membrane in one case. One case developed tympanic effusion 6 months after operation (secretory otitis media). Conclusion in patients with chronic suppurative otitis media with obstructive lesions in the upper tympanic cavity, the recurrence rate is low and the hearing effect is improved.
【作者单位】：复旦大学附属眼耳鼻喉科医院;
【分类号】：R764.92

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