儿童胆脂瘤型中耳炎的诊断与治疗

The Diagnosis and Treatment for Cholesteatoma in Pediatric Patients

目的探讨儿童胆脂瘤型中耳炎的临床特点与手术方法。方法回顾分析30例（34耳）胆脂瘤型中耳炎的临床资料，33耳行开放式手术，其中25耳行改良乳突根治术，8耳行改良乳突根治加鼓室成形术。1耳行完壁式鼓室成形术。结果术后一次性干耳30耳，干耳率94．1％，单纯行改良乳突根治的25耳中，术后听力提高8耳，不变10耳，下降7耳，其余9耳行听力重建均有不同程度的的听力提高。结论儿童胆脂瘤型中耳炎病变广泛，手术以清除病变为主，以获得干耳，在彻底清除病变后可考虑行鼓室成形术。

Objective To explore the clinical features and surgical methods for cholesteatoma in pediatric patients. Methods A retrospective analysis of the information of 30 cases （34 ears） with cholesteatoma was conducted. Out of 33 ears which received open operations, 25 ears underwent modified radical mastoidectomy, 8 ears modified canal wall-down mastoidectomy with tympanoplasty （CWD） , the rest one ear intact canal wall mastoidectomy with tympanoplasty （ICW）.Results 30 ears achieved dry ears after operations and the rate was 94.1%. Out of 25 ears which only received modified radical mastoidectomy （MRM）, pure-tone threshold average （PTA） after surgery improved in 8 ears, remained in 10 ears and declined in 7 ears. The other 9 ears which underwent auditory rehabilitation all had different degrees improvement of PTA. Conclu- sion The involved extents of cholesteatoma in pediatric patients were generally extensive, so the primary objective of surgical treatment is to clean the disease in order to acquire dry ears. Tympanoplasty can be considered after cleaning the disease completely.