自体骨粉乳突腔填充在开放式鼓室成形术中的应用

发布时间：2018-05-02 18:40

本文选题：慢性中耳炎 + 鼓室成形术　；参考：《汕头大学》2011年硕士论文

【摘要】：【目的】观察研究采用自体骨粉填充、消减乳突术腔和重建外耳道后壁对切除外耳道后壁的乳突切开鼓室成形术(Canal Wall Down Tympanomastoidectomy,CWDT)患者的近期疗效。【方法】对12例(14耳)胆脂瘤型和骨疡型中耳炎患者施行CWDT同时采用自体乳突皮质骨粉行乳突腔消减术及外耳道后壁重建术,并进行回顾性分析。【结果】经3个月～1年的随访观察,所有病例术后重建的外耳道后壁无塌陷,外耳道形态趋于正常,无一例发生狭窄;植入的鼓膜生长良好、干洁、无穿孔;与我院以前未采用自体骨粉填充的CWDT比较,干耳时间明显缩短,且无明显上皮样耵聍堆积。【结论】对于CWDT的病例,在彻底清除病灶的基础上同时行乳突腔消减与外耳道重建术,能有效地解决术后乳突空腔和外耳道缺损所遗留的问题,获得接近正常的外耳道形态,利于鼓膜的再生;同时能缩短干耳时间,并免除或减少长期清理术腔的麻烦;该术式是治疗慢性中耳炎的一种较为理想实用的手术方式;乳突皮质骨粉为理想的填充材料之一。
[Abstract]:[purpose] The study was conducted to observe the short term curative effect of canal Wall Down tympanoplasty with autogenous bone powder filling, mastoid subtraction and reconstruction of posterior wall of external auditory canal in patients undergoing mastoidotomy and tympanoplasty (CTT) after excision of the posterior wall of external auditory canal. [methods] Twelve patients with cholesteatoma and osteodontic otitis media were treated with CWDT, mastoid cavity subtraction and reconstruction of posterior wall of external auditory canal were performed with autogenous mastoid cortical bone powder. [results] Following up for 3 months to 1 year, there was no collapse in the posterior wall of the reconstructed external auditory meatus, no stenosis of the external auditory canal, and no perforation, and the implanted tympanic membrane grew well, dry and clean, and no perforation. Compared with CWDT without autogenous bone powder filling in our hospital, the dry ear time was shortened obviously, and there was no obvious epithelioid cerumen accumulation. [conclusion] For patients with CWDT, mastoid cavity subtraction and reconstruction of external auditory canal were performed simultaneously on the basis of thorough debridement of lesions, which could effectively solve the problems left by the defect of mastoid cavity and external auditory canal, and obtain close to normal shape of external auditory canal. It is beneficial to the regeneration of tympanic membrane; it can shorten the time of dry ear and eliminate or reduce the trouble of long-term cleaning of the cavity; it is an ideal and practical operation method for the treatment of chronic otitis media; the mastoid cortical bone powder is one of the ideal filling materials.
【学位授予单位】：汕头大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R764

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