中耳炎手术中后鼓室病灶的处理

Treatment of infection in posterior tympani cavity during surgical procedures of otitis media

目的:分析中耳炎手术治疗中后鼓室病灶处理的疗效。方法:资料完整的慢性中耳炎168例,66例单纯行病灶清除术,102例行病灶清除及鼓室成形术。鼓室成形术中,22例行不伴乳突凿开的鼓室成形术,53例行乳突径路鼓室成行术,27例行乳突根治并鼓室成形术。术中均探查后鼓室并仔细对该处病灶进行清理,用自体骨组织行鼓室成形术。结果:均随访1年以上,168例中获得干耳160例,8例未干耳或复发,其中骨疡型3例,胆脂瘤型5例。单纯病灶清除术患者复发1例,病灶清除及鼓室成形术患者复发7例,手术有效率为95%;鼓室成形术后平均听力提高>15dB 87例(85%)。结论:中耳炎手术中,无论采取何种手术方式及径路,都应仔细探查后鼓室,并对病灶进行清除,从而提高手术疗效。

Objective：Analyse the effect of the treatment of infection in posterior tympani cavity in 168 cases with chronic otitis media.Method：Infection was eliminated in posterior tympani cavity of all 168 cases after surgical procedures of otitis media,and 102 tympanoplasty with autoplastic bone were operated in all cases.22 tympanoplasty were operated without mastoidectomy,53 with transmastoid opproach,27 with mastoidectomy and tympanoplasty.Result：All cases were followed up for more than one year.160 cases were cured,the effective rate was 95% and no recurrence appeared except for 8 cases.The average threshold of hearing improvement of 87 cases 15 dB,the effective rate was 85%.Conclusion：To eliminate infection,the exploratory surgery of posterior tympani cavity should be done during surgical procedures of otitis media,for improving the effect of the treatment of otitis media.