鼓室成形术治疗不同类型鼓室硬化患者的近期疗效分析

An Analysis of the Clinical Curative Effects on Different Types of Tympanosclerosis with Tympanoplasty

目的探讨鼓室成形术治疗不同类型鼓室硬化患者的近期疗效。方法回顾性分析2008年2月至2011年2月间有完整资料且随访半年以上、经鼓室成形术治疗的33例鼓室硬化患者(I型8例,II型9例,III型2例,IV型14例)的临床资料,其中8例行鼓室探查+鼓膜成形术,25例行开放式乳突根治+鼓室成形术,以言语频率气导平均听力改善15dB以上或达应用听力水平为手术成功标准,评估其疗效。结果 33例患者术前言语频率气导平均听阈为54.09±9.76dB HL;术后半年随访时平均听阈为38.85±8.42dB HL,总手术成功率为63.64%(21/33),其中鼓室探查+鼓膜成形术8例中4例(50%)手术成功,开放式乳突根治+鼓室成形术25例中17例(68%)手术成功。结论鼓室成形术是治疗鼓室硬化的有效手术方法,开放式乳突根治+鼓室成形术能有效清除听骨链周围不同范围的硬化灶。

Objective To investigate the ways and efficacy of tympanoplasty on tympanosclerosis. Methods For the 33 cases, reviewed were the complete case information, six month follow-ups or more tympanosclerosis with tympanoplasty from February 2008 to February 2011 in our department. Audiological data were statistically analyzed by SPSS 13.0 software package. For the speech frequencies, air conduction hearing thresholds improved by 15 dB, or have met the criteria as defined as successful surgery. Results For the patients, the preoperative puretone thresholds at the speech frequencies showed an average of 54.09±9.76 dB after six months or more, the average was 38.85±8. 42 dB. The overall surgical success rate had achieved 63. 64% in the postoperative six months or more. The tyrnpanotomy and tympanolplasty success rates had reached 50%, and the open mastoidectomy and tympanoplastys success rates had reached 68%. Conclusion Tympanoplasty is an effective surgical treatment for tympanosclerosis. Open mastoidectomy and tympanoplasty can effectively get rid of the hardening parts surrounding he ossicular chain.