儿童胆脂瘤中耳炎术式的选择和应用

The selection of surgical technique for cholesteatoma in pediatric patients

目的:探讨儿童胆脂瘤中耳炎手术的术式选择和治疗结果。方法:对25例儿童胆脂瘤中耳炎患者的临床表现、术式、预后进行回顾性分析。18例行改良乳突根治伴鼓室成形术(开放式手术),1例行耳道完壁式乳突切开伴鼓室成形术(关闭式手术),6例行乳突根治术。结果:24例患者为一期干耳,所有患者均无胆脂瘤复发。术后气导平均听力改善7例,无改变7例,下降11例。结论:儿童胆脂瘤的病变较成人广泛,侵袭性强。手术应力求彻底清除病灶,在此基础上争取保留或改善听力。因根据患者的病变范围决定手术方式,通常多采用开放式技术。术后听力改变与术式无关,主要取决于病变的范围和程度。

Objective： To discuss the surgical treatments and results for cholesteatoma in pediatric patients. Method：A retrospective analysis of 25 cases of cholesteatoma in pediatric patients. Out of all 25 patients, 18 underwent the tympanoplasty with open technique, 1 underwent the tympanoplasty with close teehnique, and g underwent the radial mastoidectomy. Result：During the follow-up, 24 patients were cured in first-stage surgery, no recurrent cholesteatoma was observed, no observed complications occurred after surgery. Compared with the hearing thresholds of 7 patients were improved, 7 patients＇hearing thresholds had no change, and 11 patients＇ were decreased. Conclusion：The cholesteatoma in children are more widespread and erosive. The surgery should completely remove the diseased tissues and then preserve the hearing. The surgery should clear away all the lesions thoroughly, and then to conserve haring ability maximally. Surgical techniques should be chosen depending on the lesions＇ extension, generally the tympanoplasty with open technique was more suitable. The postoperative hearing decrease based on the diseased tissue and disease extension.