同种肋软骨外耳道后壁及听力重建术

Reconstruction acusticus back wall and tympanoplasty with homograft costal cartilage

目的 :消灭乳突根治术后遗留的开放乳突腔及外耳道后壁缺损。方法 :采用同种异体肋软骨对乳突根治术后 17耳行外耳道后壁重建及乳突腔充填 ,同时 期进行传音结构重建 ,其中部分听骨替换假体术式 8耳 ,全听骨替换假体术式 9耳。结果 :经 6个月～ 2年随访 ,全部病例重建外耳后壁接近正常生理结构。完全成功 14耳 ,部分成功 2耳 ,失败 1耳 ,术后 3个月鼓膜重新穿孔流脓。结论 :以同种异体肋软骨对乳突根治术后耳行外耳道后壁及听力重建术 ,是防止乳突腔感染 。

Objective:To eliminate the back wall defect of external canal and opened mastoid cavity which was remained from radical mastoidectomy.Method:We performed the operation on 17 cases after radical mastoidectomy by using reconstruction of the canal wall and fill in opened mastoid cavity and ossicular replacement prostheses made of homograft costal cartilage.The tympanoplasty had been made operated for all patients,8 ears were PORP,the others were TORP.Result:All cases were followed up for 6 months 2 years.The external canal of all patients are normal in appearance.The total effective rate of gain (>15 dB) was 14 ears ( 82.4 %).Only one patient whose tympanic membrane was perforated postoperation 3 months.Conclusion:Reconstruction of acusticus back wall and hearing after radical mastoidectomy with homograft costal cartilage is effective to prevent mastoid cavity infection and improve hearing.