开放性乳突根治术及乳突削减术治疗儿童中耳胆脂瘤

发布时间：2018-12-16 14:49

【摘要】：目的探讨开放性乳突根治术及乳突削减术治疗儿童中耳胆脂瘤的处理方法及手术疗效。方法回顾性分析采用开放性乳突根治术及乳突削减术治疗5~12岁中耳胆脂瘤儿童病例32例。手术方式为开放性乳突根治术,同时以自体乳突皮质骨粉行乳突填充、重建外耳道后壁耳道成形。32例完成了2年以上的术后随访。结果完成随访的32例患儿,术后胆脂瘤复发率3.1%(1/32)。31例患儿术后10~12周达到干耳,干耳率为96.9%。32例病例均未出现明显手术并发症。术后1年复查听力,与术前听力对比,差异有统计学意义(P0.01)。乳突腔填充骨粉外耳道成形术后外耳道形态良好。结论儿童胆脂瘤的病例,在彻底清除病灶的基础上同时行自体骨粉乳突填充及外耳道成形术,恢复外耳道解剖形态,可有效预防术后内陷袋形成,减少胆脂瘤复发的潜在危险,提高听力。自体乳突皮质骨粉为理想填充材料。
[Abstract]:Objective to explore the treatment and effect of open mastoidectomy and mastoid reduction in children with middle ear cholesteatoma. Methods 32 cases of middle ear cholesteatoma were treated with open mastoidectomy and mastoid reduction. Open mastoidectomy with autogenous mastoid cortical bone powder was performed to reconstruct the posterior wall of external auditory canal. 32 cases were followed up for more than 2 years. Results the recurrence rate of cholesteatoma was 3.1% (1 / 32) in 32 cases, and dry ear was reached in 31 cases 10 ~ 12 weeks after operation, the dry ear rate was 96.99..32 cases had no obvious complications. 1 year after operation, the hearing was compared with the preoperative hearing, the difference was statistically significant (P 0.01). The shape of the external auditory meatus was good after mastoid cavity filling with bone powder. Conclusion in children with cholesteatoma, autogenous bone powder mastoid filling and external auditory canal angioplasty are performed simultaneously on the basis of thorough debridement of the lesions, which can effectively prevent the formation of invagination bags and reduce the potential risk of recurrence of cholesteatoma. Improve your hearing. Autogenous mastoid cortical bone powder is the ideal filling material.
【作者单位】：中山大学附属第一医院耳鼻咽喉科;
【基金】：广东省科技计划项目(编号:2012B031800027)
【分类号】：R764.9

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