耳甲腔外耳道成形在开放式乳突手术中的应用

The application of meatoplasty and conchoplasty in the open mastoidectomy

目的:探讨耳甲腔成形在开放式乳突术中的应用价值。方法:80例慢性化脓性中耳炎患者行开放式乳突手术,其中38例行四瓣法耳甲腔成形(成形组),42例未行耳甲腔成形(对照组),对2组疗效进行相关分析比较。结果:成形组术后干耳时间为17.18 d,肉芽生长发生率为5.26%(2/38),术腔感染再干耳时间为4.58d;对照组干耳时间为25.50 d,肉芽生长发生率为21.43%(9/42),术腔感染再干耳时间为9.64 d,2组比较均差异有统计学意义。2组术后复发、耳鸣及头晕的发生率差异均无统计学意义。结论:本文耳甲腔成形操作简单易行,能有效改善术腔通气引流,缩短干耳上皮化时间,清理方便,减少患者术后复诊次数,减轻随访难度及工作量,值得在开放式乳突手术中提倡应用。

Objective：To explore the clinical value of conchoplasty in open mastoidectomy. Method：Eighty cases with chronic otitis media underwent open mastoidectomy and the effects were analyzed and compared between 38 cases with conchoplasty （plastic group） and 42 cases without conchoplasty （control group）. Result：The patients got dry ear in 17.18 days after operation and the mean time of dry ear was 4.58 days after mastoid cavity infection in the plastic group of which 2 cases had granulation in the cavity （5.26%）. In the control group, they were 25. 50 days,9.64 days and 21.43%（9/42） respectively. The difference had statistical significance. But the occurrence of tinnitus, dizziness and recurrence after operation showed no obvious difference between the two groups. Conclusion： The conchoplasty is easy to perform which can improve the ventilation of mastoid cavity and shorten the process of epithelization. At the same time, the conchoplasty can make it very convenient to clean up the cavity and to decrease the difficulty of follow-up. It is worthy to be applied in the open mastoidectomy.