中耳胆脂瘤开放式改良乳突根治术后不干耳的治疗

Treatment of wet ear in patients with middle ear cholesteatoma after modified open radical mastoidectomy

目的总结中耳胆脂瘤开放式改良乳突根治术后不干耳的治疗体会。方法回顾性分析2008年1月-2012年12月66例中耳胆脂瘤患者的临床资料，男36耳，女30耳，年龄9～54岁，均行开放式改良乳突根治术，以术耳干耳时间为标志，对术腔的转归预后进行随访。结果54耳术后1个月内干耳，术腔上皮化。余12耳术腔反复长肉芽、流脓，经刮除肉芽、地塞米松磷酸钠注射液反复灌洗术腔、氯霉素地塞米松纱条换药。2个月内干耳，术腔上皮化。此12例患者年龄在16～33岁，而其余54例极少数位于该年龄段。结论开放式改良乳突根治术后不干耳主要发生于青年中耳胆脂瘤患者，其实质为肉芽生长型，肉芽刮除及预防对干耳很重要。

Objective To summarize the treatment of wet ear in patients with middle ear cholesteatom after modified open radical mastoidectomy. Methods A retrospective analysis was made to the clinical data of 66 patients with middle ear eholesteatoma; the patients all underwent modified open radical mastoideetomy during the period from Jan. ,2008 to Dec. ,2012, of whom there were 36 ears from male and 30 ones from female, and they were from 9 to 54 years old; follow-up was made to the prognosis till their ears turned dry. Results 54 ears of 66 ones turned dry with the epithelization in the operation cavity in a month after the operation. While the left 12 ears had more treatment clue to repeated growth of granulation in the operation cavity and pyorrhea, including scrapping, repeated cavity lavage with dexamethasone sodium phosphate injection and dressing changes with gauze of mixed chloramphenicol and dexamethasone;and at last these ears turned dry with epithelization in operation cavity. The 12 ears came from 12 cases who were aged between 16 to 33 years, while other 54 cases were fewer at this age range. Conclusions Wet ear after modified open radical mastoidectomy mainly occurs in young cases with middle ear cholesteatom clue to the growth of granulation;it is important to scrip the granulation and to make proper prevention.