鼓室硬化症鼓室成型术25例临床分析

Tympanoplasty for tympanosclerosis: a clinical analysis of 25 cases

目的:总结手术治疗鼓室硬化症的临床经验。方法:回顾性总结2001年11月至2005年2月我科经治的25例鼓室硬化症临床资料。手术均在全麻显微镜下采用剥除硬化灶,修补鼓膜或加听骨链重建行Ⅰ期鼓室成型术。采用颞肌筋膜修补鼓膜,以自体乳突骨皮质或陶瓷人工听骨重建听骨链。结果:病灶侵及鼓膜、鼓岬、砧锤骨、镫骨及周围,均呈板障型乳突,无并发胆脂瘤。听力提高15 dB以上24例(96%),术后4例有眩晕。结论:尽量清除硬化灶,形成宽大的鼓室,并重建鼓膜和听骨链,手术疗效与病灶影响听骨链程度有关,精确、熟练的耳显微外科技术是成功的关键。

Objective： To summarize the experience of treatment for tympanosclerosis. Methods： The clinical data of 25 cases of tympanosclerosis undergoing tympanoplasty from November 2001 to February 2005 were retrospectively analyzed. Tympanoplasty of grade I was performed on all patients. In the operation, temporal fascia was used to repair the drum and self cortex of mastoid bone or aaificial porcelain auditory ossicles were used to reconstruct the ossicular chain. Results： The lesion intruded into drum, promontory of tympanum, incudomalleus, stapes and its surroundings, and no cholesteatoma accompanied by. After operation, the hearing upregulated by 15 dB（96% ） in 24 patients and vertigo was found in 4. Conclusions： To clear a sclerotic region around the stapes and to reconstruct ossicular chain and tympanic membrane are the key points of success. The response is closely related with the sclerotic region around the ossicular chain.