两种鼓室成形术临床疗效对比观察

Clinical analysis of 85 ossiculoplasty cases

目的比较伴乳头切除的鼓室成形术及不伴乳突切除的鼓室成形术两种方法在鼓室成形术后的听力改善状况。方法收集2010年1月至2012年1月85例慢性化脓性中耳炎患者,根据手术方式分为两组,其中伴乳头切除的鼓室成形术(A组)43例45耳,不伴乳突切除的鼓室成形术(B组)42例42耳,比较两组术后1年听力情况。结果随访1年,两组术后0.25～4.00 kHz频率听力均较术前明显提高,差异有统计学意义(P<0.05);B组在0.25 kHz频率听力提高更为明显(P<0.05);B组在8.00 kHz及PTA频率听力较术前明显提高(P<0.05)。结论在严格掌握适应证的情况下,鼓室成形术能重建听骨链,有效改善患者听功能,不伴乳突切除术的鼓室成形术对患者听功能改善更为明显。

Objective To compare the hearing improvement in tympanoplasty with mastoidectomy or without mastoidectomy.Methods There was a retrospective analysis of 85 cases chronic suppurative otitis media patients of our hospital from January 2009 to January 2011.They were divided into two groups,43 cases of tympanoplasty with mastoidectomy（the group A） and 42 cases of tympanoplasty without mastoidectomy（the group B）.The hearing outcomes 1 year after operation were compared.Results The hearing improvement between 0.25 ～ 4 kHz in the two groups after one year follow-up were significantly higher than before the operation（P 0.01 or 0.05）;the hearing improvement of 0.25 kHz in the group B was significantly higher than in the group A（P 0.05）;the hearing improvement of 8kHz and PTA were significantly higher than before the operation（P 0.05）.Conclusion Tympanoplasty can yield high rates of air-bone gap reduction if operation indications were controlled strictly,tympanoplasty without mastoidectomy was better than with mastoidectomy.