鼓膜微型管置入术治疗中耳不张32例

Placement of a tympanostomy microtube to treat middle ear atelectasis in 32 cases

目的探讨鼓膜微管置入术治疗中耳不张的手术方法和临床疗效。方法回顾分析32例(34耳)中耳不张的患者病历资料。选择耳闷就诊患者,进行耳镜、听力和鼓室导抗检查,并在局麻或全麻下行鼓膜微管置入术,术后随访2～6个月。结果置管成功34耳,术后耳闷症状消除30耳,声导抗提示鼓室图由"C"型恢复为"A"型,纯音听阈测试提示听力提高5～15 dB。没有患者出现感染、鼓膜穿孔和鼓室硬化等并发症。结论鼓膜微管置入术治疗中耳不张,不需鼓膜切开,损伤小,效果显著,具有临床应用价值。

Objective To investigate the medical efficacy of tympanostomy microtube placement in the treatment of middle ear atelectasis.Methods 32 cases（34ears） of middle ear atelectasis underwent tympanostomy microtube placement under general or local anesthesia.Operations and clinic data were all reviewed.Prior to the treatments,all patients presented fullness or pressure in the ear.Otoscope,hearing and tympanogram examination were performed and follow-ups were 2 to 6 months after the operation.Results All cases were successfully operated.Before the treatments,acoustic immittance tests showed type ＂C＂ tympanogram in all 34 ears.After the treatment,the fullness disappeared in 30 ears and types ＂A＂ tympanograms were found in all the ears.The pure-tone average（PTA）of hearing thresholds were significantly improved with an average elevation of 5 to 15 dB.No complications,such as middle ear infection,tympanosclerosis,or permanent perforation,was found.Conclusions The placement of a tympanostomy microtube,which is minimally invasive without myringotomy,proves to be a simple,effective way to treat middle ear atelectasis.