单纯鼓室成形术后继发胆脂瘤——附5例报告

Second cholesteatoma of postoperative tympanoplasty-Report of 5 cases

目的 :探讨单纯鼓室成形术后发生胆脂瘤的原因并提出预防措施。方法 :对 5例单纯鼓室成形术后继发胆脂瘤患者的临床资料进行分析。结果 :单纯鼓室成形术后胆脂瘤形成 ,多与角化鳞状上皮残留有关 ,而且局部解剖特点、鼓膜穿孔后表皮生长特点及术者的手术操作与角化鳞状上皮的残留关系密切。结论 :只要术前仔细、全面的检查 ,术中认真操作 ,就会大大降低继发胆脂瘤的发生 ,确保手术成功。

ABSTRACT Objective:To investigate the reasons of the second cholesteatoma of postoperative tympanoplasty.Methods:The clinical data of second cholesteatoma of postoperative tympanoplasty were analyzed retrospectively in 5 patients from 1991 to 1999.The diagnosis of second cholesteatoma was made 1 to 2 year after first operation.The management of second cholesteatoma was to remove the cholesteatoma,and receive tympanoplasty again .Results:The curative effect was successful for all 5 patients in the period of follow up 1 to 5 years.The reasons of the second cholesteatoma found that the remnant of squamous epithelium elements were important factors.Conclusion:The attentive examination in the pre operation,careful treatment in the operation under surgical microscope were important procedure to avoid second cholesteatoma.