上鼓室、鼓窦胆脂瘤切除一期鼓室成形术的疗效观察

Clinical observation of the elimination of lesions in a tympanoplasty in ossicular chain reconstruction

目的探讨局限于上鼓室、鼓窦的胆脂瘤彻底清除病变行一期鼓室成形、听骨链重建术,以达到彻底清除病灶与保存并提高听力的双重目的的临床疗效。方法对30例局限于上鼓室鼓窦的胆脂瘤中耳炎患者行上鼓室、鼓窦胆脂瘤切除一期鼓室成形术。结果 30例患者定期随诊2年以上,所有病例上鼓室外侧壁及鼓膜松弛部愈合良好,无复发。术后气骨导差<10dB18例,<20dB9例,<30dB2例,30dB以上1例。术后听力提高20～30dBHL2耳,提高15～20dBHL11耳,提高10dBHL14耳,无变化3耳。该组病例的传音功能基本保留和恢复,术后随访听力基本稳定,无眩晕及耳鸣等并发症。结论局限性于鼓室、鼓窦的胆脂瘤在彻底清除病变基础上行一期鼓室成形术,可达到彻底清除病灶与保存并提高听力的双重目的 。

Objective To discuss the attic,tympanic sinus cholesteatoma in the elimination of lesions in a tympanoplasty,ossicular chain reconstruction,to achieve complete removal of disease and to save and improve the hearing of the dual purpose of clinical efficacy. Methods 30 cases of limited attic cholesteatoma otitis media drum sinus patients attic,tympanic sinus cholesteatoma removal of a tympanoplasty. Results 30 patients were regularly followed up for more than two years,all patients on the drum and the drum wall outside relaxation Division healed without recurrence. Postoperative air-bone gap〈 10 dB 18 cases,〈20 dB 9 cases,〈30 dB 2 cases,30 dB or more in 1 case. Postoperative improvement of hearing 20~30 dBHL 2 ears,increase 15-20 dBHL 11 ears,raising 10 dBHL 14 ears,unchanged in 3 ears. Sound transmission of the group of cases to retain and restore the basic functions,postoperative follow-up hearing basically stable,no complications such as dizziness and tinnitus. Conclusions The attic,tympanic sinus cholesteatoma in the elimination of lesions based on a tympanoplasty can be achieved by complete removal of disease and preservation of the dual purpose of improving hearing.