慢性活动期化脓性中耳炎咽鼓管功能障碍一期鼓室成形术的效果

Effects of phaseⅠtympanoplasty in active chronic suppurative otitis media with eustachian tube dysfunction

目的：探讨慢性活动期化脓性中耳炎咽鼓管功能障碍一期鼓室成形术的效果。方法总结分析我科2008-06～2013-10对87例（耳）活动期慢性化脓性中耳炎咽鼓管功能障碍患者行完壁式乳突根治一期鼓室成形手术病例中资料完整的70例，随访1年，对术后鼓膜愈合率、听力恢复情况进行分析。结果68例鼓膜愈合，成功率97．14％（68／70），无移植物外移、钝角愈合、鼓膜萎缩、胆脂瘤形成、感音神经聋及外耳道真菌感染；术前平均气导听阈值为（42．7±4．6） dB，骨气导差为（27．5±3．1）dB，术后平均气导听阈值为（30．3±5．3）dB，骨气导差为（15．1±3．0）dB，听力较术前明显提高（P＜0．01），其中53例骨气导差＜20 dB，占77．94％。结论慢性活动期化脓性中耳炎咽鼓管功能障碍只要手术处理得当和术后治疗的跟进，可以获得良好的效果，有临床推广价值。

Objective To investigate the effect of phase Ⅰtympanoplasty on active chronic suppurative otitis media with Eu-stachian tube dysfunction.Methods 70 patients with complete data from 87 patients（ ears） who suffered from active chronic suppura-tive otitis media with Eustachian dysfunction were recruited and received the intact canal wall mastoidectomy and phaseⅠtympanoplas-ty in this department from June 2008 to October 2013.They were followed up for one year, and their healing rates of the eardrum and hearing restoration were analyzed.Results 68 cases had eardrum healing, with a success rate of 97.14 %（68/70）.There was no graft shift, obtuse healing, atrophic eardrums, cholesteatoma formation, sensorineural hearing loss or fungal infections in external audi-tory canals.The preoperative average hearing level of air conduction was （42.7 ±4.6）dB, and the average gap between bone conduc-tion and air conduction was （27.5 ±3.1） dB.The postoperative average hearing level of air conduction was （30.3 ±5.3）dB, and the average gap between bone conduction and air conduction was （15.1 ±3.0）dB, which was significantly improved （P〈0.01）, in which 53 cases with less than 20 dB gap between bone conduction and air conduction, the rate was 77.94%.Conclusions Active chronic suppurative otitis media with Eustachian dysfunction undergoing effective surgery and postoperative treatment can achieve good results and worth popularizing in clinic.