儿童胆脂瘤型中耳炎手术效果观察

Studying the effect of surgery for cholesteatoma in children

目的:探讨手术治疗对儿童胆脂瘤型中耳炎听觉功能的影响。方法:回顾性分析5年间行手术治疗的62例儿童中耳炎患者。其中60例为后天性胆脂瘤,2例为先天性胆脂瘤。48例病变广泛需行开放式(去除外耳道后壁)乳突凿开术,12例上鼓室胆脂瘤者行完壁式(保留外耳道后壁)的乳突凿开术,2例病变位于中耳腔者行鼓室探查术。结果:手术治疗后42例听力提高,13例维持原有听力,7例听力下降。其中,3例由于病变复发行二次手术。结论:本研究提示儿童胆脂瘤型中耳炎有较强的侵袭性,为提高治疗效果需加强术前分析、完善手术操作技术及术后随诊。

Objective:To study the impact of surgical treatment on hearing for cholesteatoma in children.Method:The retrospective survey was carried out in 62 children with cholesteatoma treated surgically over a 5-year period.Sixty patients had acquired cholesteatoma and two had congenital cholesteatoma.Forty-eight patients had extensive invasion that required canal wall-down mastoidectomy.Twelve patients with attic cholesteatoma underwent canal wall-up mastoidectomy,and 2 patients with cholesteatoma localized to the middle-ear space were adequately treated with tympanic exploration.Result:Hearing was improved in 42 cases,preserved in 13 cases, became worse in 7 cases.A secondary surgical procedure for recidivistic (recurrent or residual) disease was peformed in 3 cases.Facial paralysis was noted in 2 patients before surgical operation,and 2 patients had sensorineural hearing loss.Conclusion:This study confirmed the aggressiveness of cholesteatoma in children and demonstrated the need for careful preoperative evaluation, meticulous surgical technique, and prudent postoperative follow-up.