乳突根治术后病例鼓室成形术的疗效探讨

Analysis of reoperations after radical mastoidectomy

目的总结乳突根治术后长期流脓患者鼓室成形术的疗效。方法对63例乳突根治术后长期不干耳患者再次施行乳突根治术,同时行乳突充填术及鼓室成形术。结果所有患者经1～2月局部换药均获干耳,外道形态接近自然宽大的外耳道,气导听力较术前获得改善。结论病灶清除不彻底,术腔难于清理是乳突根治手术失败的主要原因。乳突腔彻底开放,轮廓化,适度充填乳突腔,配合鼓室成形术,可以获得近似正常的外耳道,并且能有效改善听力。

Objective To evaluate the surgical outcome of patients undergoing obliteration and tympanoplasty of a persistently discharging mastoid cavity after radical mastoidectomy. Methods 63 cases of wet ear after radical mastoidectony were performed radical mastoidectomy again, obliteration and tympanoplasty was performed at the same time. Results All cases achieved a dry ear after mastoidectomy 1 ～ 2 months. All cases of revision mastoidectomy achieved a not-big, dry, and healthy mastoid cavity, with lightly improved hearing leve1. Conclusions To eliminate pathological tissue thoroughly, to remain good drainage after operation, are keys to prevent reoperation. For all the cases , opening and contouring mastoid cavity thoroughly with simultaneously obliteration and tympanoplasty was surgical procedure, to acquire approximately normal external acoustic meatus and hearing improvement.