陈旧性乳突术后全中耳重建术的听力变化

Hearing results of the total middle ear reconstruction for radicalized ear

目的 :探讨利用自体软骨进行听骨链成形的全中耳重建术患者听力恢复的可能性。方法 :对 6 5例(6 9耳 )慢性化脓性中耳炎乳突手术后出现复发性耳漏再手术者 ,术中同时利用自体软骨进行Ⅲ或Ⅳ型鼓室成形术。比较手术前后听力的变化。结果 :全中耳重建术后 4 5耳 (6 5 .2 % )成功提高了听力 ,Ⅲ型者听力成功率为74 .2 % (2 3耳 ) ;Ⅳ型者听力成功率为 5 7.9% (2 2耳 )。全部患者平均听力提高 1 0 .6dBnHL。结论 :全中耳重建术可有效地提高陈旧性乳突手术后患者的听力 ,存在镫骨者的听力成功率要好于镫骨缺失者 ;

Objective:Total middle ear reconstruction can satisfactorily treat the problematic mastoidectomy cavities in patients following previous open mastoidectomy. Although the first also the most important objective is to get a dry ear, another objective to improve the hearing is important, too. Our aim is to evaluate the success of hearing results of total middle ear reconstruction with cartilage ossiculoplasty for the patients with old open mastoidectomy cavities.Method:We had a retrospective review of 65 patients who underwent total middle ear reconstruction with cartilage ossiculoplasty. Postoperative pure tone average air bone gap for four frequencies 500, 1 000 ,2 000,4 000 were compared with preoperative level.Result:In this series, the success hearing results were obtained in 65.2 % of the patients after operation, but 93% of the ears were dry. The success rate was 74.2 % in patients with stapes and 57.9 % in patients without stapes. The mean hearing gain was 10.6 dB.Conclusion:Total middle ear reconstruction offers an effective treatment algorithia of hearing reconstruction for patients with old mastoidectomy cavities. 1 stapes is important for the hearing improvement.2 staged operation is good for hearing restoration.3.For a large number of patients with a problematic cavities, hearing restoration is possible by total middle ear reconstruction.