自体皮质骨上鼓室重建及骨粉填塞乳突腔在乳突切除鼓室成形术中的应用

Application of autogenous bone pate for atticus reconstruction and mastoid cavity obliteration in tympanoplasty with mastoidectomy

目的:观察在改良乳突根治术并鼓室成形术中,应用自体皮质骨行上鼓室外侧壁重建及骨粉填塞乳突腔对胆脂瘤伴中耳炎治疗的临床疗效。方法:将60例(60耳)胆脂瘤伴中耳炎患者随机分为实验组和对照组,对照组仅行改良乳突根治术并鼓室成形术,实验组在行改良乳突根治术并鼓室成形术基础上应用自体乳突皮质骨行上鼓室外侧壁重建,术后随访0.5～2年,回顾性观察2组患者在干耳时间、听力提高等方面的恢复情况,进行疗效对比分析。结果:2组患者在鼓膜状态、干耳时间、听力提高等方面差异有统计学意义(P<0.05)。结论:在改良乳突根治术并鼓室成形术的基础上,重建上鼓室外侧壁,可以保证听骨链的正常活动空间,术后听力改善疗效满意,缩短了干耳时间,减少手术并发症。

Objective：To observe the curative effect of autogenous bone pate for atticus reconstitution and mastoid cavity obliteartion in canal wall down mastoidectomy with tympanoplasty.Method： The 60 patients（60 ears） of cholesteatomatous tympanitis were randomly divided into 2 groups.The experimental group underwent canal wall down mastoidectomy with tympanoplasty and using autogenous bone pate for atticus reconstitution and mastoid cavity obliteration.The control group only underwent canal wall down mastoiddectomy with tympanoplasty.All patients were followed up for 0.5-2 years.Improvement of hearing and dry ear time in these two groups was retrospectively observed.Results： There are significant difference between two groups in improvement of hearing and dry ear time,according to follow-up and analysis of therapeutic efficacy（P0.05）.Conclusion： Hearing can be improved,dry ear time can be shorten and correlative complication can be decreased by atticus reconstruction and mastoid cavity obliteration with autogenous bone pate in canal wall down mastoidectomy with tympanoplasty,which guarantees the normal activity space of auditory bone chain.