胆脂瘤型中耳炎并发面瘫的时间及程度对手术效果的影响

Effect of the onset time and degree of cholesteatoma otitis media complicated with facial paralysis on surgical efficacy

目的分析胆脂瘤型中耳炎面瘫的时间及程度对手术效果的影响。方法回顾性分析45例采用开放式乳突切除并面神经减压手术治疗胆脂瘤型中耳炎并发面瘫患者的临床资料,分析面瘫的时间及程度对手术效果的影响。结果 45例中痊愈28例,显效4例,有效9例,无效4例。患者面瘫发病时间为2～10 d、11～30 d的效果明显优于面瘫发病时间〉30 d者（均P〈0.01）;轻度、中度面瘫患者的疗效也明显优于重度面瘫者（均P〈0.01）。结论胆脂瘤型中耳炎并发面瘫患者的术后恢复受面瘫病程长短及面瘫严重程度的直接影响,故应采取积极措施预防疾病的进展并及早进行手术。

Objective To analyze the effect of the onset time and degree of cholesteatoma otitis media complicated with facial paralysis on surgical efficacy. Methods The clinical data of 45 patients with cholesteatoma complicated with facial paralysis who were treated in our hospital from January 2003 to September 2015 were retrospectively analyzed. All the patients received open mastoidectomy and facial nerve decompression surgery. The effect of the onset time and degree of cholesteatoma otitis media complicated with facial paralysis on surgical efficacy was analyzed. Results Of the 45 cases, 28 cases were cured, of which there were 4 markedly effective cases with, 9 effective cases and 4 ineffective cases. The total cure rate was 91.1%（41/45）. The total effective rate of the patients with their onset time of 2-10 d and 11-30 d was significantly higher than that of the patients with their onset time 〉30 d（P〈0.01）; and the efficacy in the patients with mild and intermediate facial paralysis was also significantly superior to that in the patients with severe facial paralysis（P〈0.01）. Conclusion The postoperative recovery of the patients with cholesteatoma otitis media complicated with facial paralysis is directly influenced by the duration and severity of facial paralysis, therefore, measures shall be actively taken to prevent the progress of the disease and surgery shall be performed as soon as possible.