胆脂瘤型中耳炎乳突根治加同期鼓室成形术187例疗效观察

Observation of curative effect of cholesteatoma otitis media in 187 patients treated by radical mastoidectomy and synchronal tympanoplasty

目的探讨胆脂瘤型中耳炎乳突根治加同期鼓室成形术的疗效。方法对187例胆脂瘤型中耳炎患者经乳突进路行乳突根治,辅以耳内镜清除病灶,并同时一期完成鼓室成形术。结果随访>2年,术后外耳道基本正常,鼓膜形态良好,鼓膜成活180耳(96.3%),获干耳180耳(96.3%),听力提高>25dB86耳(46%)>15dB85耳(45.5%),无提高16耳(8.5%),总有效率91.5%。术后出现外耳道狭窄3耳,鼓索神经损伤2耳,面瘫1耳,鼓膜穿孔7耳。结论胆脂瘤型中耳炎患者行开放式乳突根治,利于清除病灶,辅以耳内镜的应用,病变清除彻底同期听力重建术后疗效满意,并发症少,复发率低,但尚待进一步临床观察。

Objective To explore the curative effect of cholesteatoma ofitis media treated by mastoidectomy and synchronal Tympanoplasty.Methods 187 patients of cholesteatoma otitis media were treated by radical mastoidectomy through mastoidal approach accompanied with clearation of diseased region by endotoscope and synchronal tympanoplasty. Results All cases were followed up for 2 years. External acoustic meatus was normal and the tympanic membrane foma was prity good. The tympanic membrane survival rate was 96.3% （180ear）,dry ear rate was 96.3% （180ear）, The rate of enhanced heating to 25dB was 46% （86ear）, above 15dB 45.5% （85ear）,8.5% （16ear） with no change, the total effective rate was 91.5%. External acoustic meatus stenosis occurred in 3 cases postoperatively, chroda nerve inured in 2 case. facial paralysis occurred in i case. tympanic membrance perforation in 7 case. Conclusion To treat the choloresteatoma otitis media by opened mastoidectmy accompanied with endotoscopy. We take the advantage in removing the diseased region completely and reconstructing the hearing. The curative effect is satisfied with low complications and recurrence. further clinical observation is repuired.