软组织耳道后壁重建并鼓室成形术治疗中耳胆脂瘤的临床疗效观察

发布时间：2018-09-12 17:41

【摘要】：目的初步探讨采用颞肌骨膜瓣转移外耳道后壁重建技术,修复开放式乳突根治术后外耳道后壁缺损及开放的乳突腔,提高听力、重建外耳道解剖及功能、降低胆脂瘤复发率的临床意义。方法将103例胆脂瘤型中耳炎患者分成三组,A组(研究组)45例行开放式乳突根治术,采用颞肌骨膜瓣转移耳道后壁重建技术同时重建中耳鼓室传音结构;B组(对照组)36例行经典的完壁式乳突切除术;C组(对照组)22例行开放式乳突根治术。A组分别与B、C组在术后听力改善率、干耳率、平均干耳时间、胆脂瘤复发率及外耳道功能良好率几方面进行统计学分析。结果 A组与B组在术后听力改善率、术后干耳率、术后平均干耳时间、外耳道功能良好率差异无显著性,术后胆脂瘤复发率明显降低,差异有显著性。A组与C组比较在术后听力改善率、术后平均干耳时间有显著的提高,外耳道结构及功能得到修复。结论软组织耳道后壁重建并鼓室成形术,在胆脂瘤型中耳炎行乳突切除术中能使病灶彻底得到清除、降低并发症,外耳道原有形态及功能得以修复,又能改善听力,且手术易操作;根据术中情况灵活应用该手术方式可显著降低整组病例术后胆脂瘤复发率;具有临床应用价值。
[Abstract]:Objective to explore the technique of reconstruction of posterior wall of external auditory canal with temporalis periosteum flap transfer, repair the defect of posterior wall of external auditory canal and open mastoid cavity after open mastoidectomy, improve hearing, reconstruct anatomy and function of external auditory canal. Clinical significance of reducing recurrence rate of cholesteatoma. Methods 103 cases of cholesteatoma type otitis media were divided into three groups: group A (study group), 45 patients with open mastoidectomy. Reconstruction of posterior wall of auricular canal with temporalis periosteum flap and reconstruction of tympanic ventricular sound transmission structure in group B (control group) 36 cases were treated with classical wall mastectomy. Group C (control group) 22 cases underwent open mastoidectomy. Group A was treated with open mastoidectomy, respectively. The rate of hearing improvement in group C and group B was improved after operation. The dry ear rate, mean dry ear time, recurrence rate of cholesteatoma and good function of external auditory canal were analyzed statistically. Results there was no significant difference between group A and group B in the improvement rate of hearing, the rate of dry ear, the average dry ear time, the good function of external auditory canal, and the recurrence rate of cholesteatoma after operation. There was significant difference between group A and group C in the improvement rate of hearing, the average dry ear time and the repair of the structure and function of external auditory canal. Conclusion the reconstruction of the posterior wall of soft tissue ear canal and tympanoplasty, mastoidectomy in cholesteatoma type otitis media, can completely clear the focus, reduce complications, repair the original shape and function of external auditory canal, and improve hearing. It is easy to operate and can reduce the recurrence rate of cholesteatoma in the whole group according to the condition of the operation.
【作者单位】：福建医科大学附属宁德市医院耳鼻咽喉科;
【基金】：宁德市科技局科研立项资助项目(No:宁科20100077)
【分类号】：R739.61

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