完壁式乳突根治并鼓室成形术治疗中耳炎效果观察

Observation on curative effects of complete wall mastoidectomy and tympanoplasty on otitis media

目的探讨采用完壁式乳突根治术并鼓室成形术治疗中耳炎的临床效果。方法收集采用完壁式乳突根治术联合鼓室成形术治疗的88例中耳炎患者(97耳)的临床资料,进行回顾分析。结果本组88例(97耳)于治疗后获得0.5年的随访,鼓膜全部愈合,且均获得干耳。鼓膜愈合时,6例(6耳)患者出现鼓膜内陷的现象,活动性能较差。所有患者均未出现内耳损伤、面神经损伤或者其他并发症。相比于术前的纯音听力,11例(13耳)提高≥30 dBHL,34例(36耳)提高20～29 dBHL,22例(22耳)提高10～19 dBHL,21例(26耳)未有变化。结论采用完壁式乳突根治术联合鼓室成形术治疗中耳炎,可有效清除中耳病灶,重建听骨链,提升患者听力,且可以尽量保留耳部正常形态,有推广价值。

Objective To investigate the curative effects of complete wall mastoidectomy and tympanoplasty on otitis media. Methods The clinical data of 88 patients with otitis media （ 97 ears ） who received complete wall mastoidectomy combined with tympanoplasty were colleted and retrospectively analyzed. Results The group of 88 cases （ 97 ears） received half a year of follow-up. Their tympanic membranes were all healed, and they all got dry ears. At the time of Tympanic membrane healing, there were 6 cases （6 ears） with retracted tympanic membrane and poor reactiveness of the membrane. No patient experienced an inner ear injury, facial nerve injury or other complications. Compared with the preoperative pure tone audiometry, that of 11 cases （ 13 ears ） increased by 30 dBHL and above;that of 34 ones（36 ears）increased by 20 to 29 dBHL;that of 22 ones（22 ears）increased by 10-19 dBHL. However, that of 21cases（ 26 ears ） did not change. Conclusion The treatment of otitis media by complete wall mastoidectomy combined with tympanoplasty can effectively remove the middle ear infection focuses, reconstruct the ossicular chain, enhance patients＂ hearing, and try to keep the normal morphology of the ear. This treatment is worthwhile to be promoted.