开放式鼓室成形术并Ⅰ期听力重建应用探讨

Canal wall-down tympanoplasty and simultaneous auditory rehabilitation

目的探讨开放式鼓室成形术并Ⅰ期听力重建的临床疗效。方法对慢性化脓性中耳炎13例(耳)实施开放式鼓室成形术并Ⅰ期听力重建,与同期传统的乳突根治术38例(耳)进行疗效和听力学比较。结果术后随访6个月至6年,开放式鼓室成形术者均干耳,无复发,11耳(84.6%)术后气导纯音听阈均值(PTA)获得保持或提高;乳突根治术中20耳(52.6%)术后再流脓、反复霉菌感染和再手术,9耳(31.0%)术后气导PTA保存或提高,两者差异显著。结论开放式鼓室成形术手术适应证广泛,干耳率高,复发率低。术中根据中耳乳突炎性反应程度的不同,适当调整手术操作,以重建听力,术后多可保存或提高听力。

Objective To explore the therapeutic effects of canal wall-down tympanoplasty （CWdT） on chronic otitis media and evaluate the effects of simultaneous auditory rehabilitation. Methods 13 cases on chronic otitis media with cholesteatoma and/or granulation tissue were treated by CWdT, the effects were contrast with radical mastoidectomy. Results After 6 months to 6 years oic follow-up, all the cases by CWdT had dry ear without recurrence. The rate of hearing restoration and improvement was 84.6 % from the cases. In same times, the rate of recurrence, hearing restoration and improvement was 52.6 % , 31.0 % from the mastoidectomies. Conclusion The CWdT has advantage in indication,removal of lesions and the operation could be adjusted appropriately for simultaneously auditory rehabilitation.