胆脂瘤型中耳炎并发迷路瘘管的手术治疗

Surgical treatment of labyrinthine fistula caused by cholesteatoma otitis media

目的探讨胆脂瘤型中耳炎并发迷路瘘管的手术方法与疗效。方法对1998年1月～2007年1月手术治疗的胆脂瘤型中耳炎并发迷路瘘管20例(耳),全部病例行一期修复瘘管,其中行单纯筋膜修复9耳,行自体骨粉加筋膜修复11耳。结果术后随访1～10年,单纯筋膜修复术后转动头部仍有眩晕者2耳,自体骨粉加筋膜修复者术后无眩晕发生。结论胆脂瘤型中耳炎并发迷路瘘管,清除病灶后可以一期修复,用自体骨粉加筋膜修复迷路瘘管是较理想的方法。

Objective To evaluate the surgical management and effect of labyrinthine fistula caused by cholesteatoma otitis media. Method 20 cases （ears） with labyrinthine fistula caused by cholesteatoma otitis media were managed by operation between January 1998 and January 2007. All cases were repaired in first-stage： 9 ears only with fascia, llears with homologous bone dust and fascia. Result All cases were followed up for 1 to 10 years.2 ears of which were repaired only with fascia still felt vertigo when turning the head. The cases which were repaired with homologous bone dust and fascia had control of vertigo.Conclusion The labyrinthine fistula caused by cholesteatoma otitis media can be removed focus and repaired in first-stage. The method of repairing the labyrinthine fistula with homologous bone dust and fascia is an approoriate procedure.