保留部分外耳道后壁上鼓室切开软壁重建术治疗中耳胆脂瘤

The technique of retaining part of the external auditory canal posterior wall with epitympanoplasty in soft wall reconstruction treating middle ear cholesteatoma

目的:探索中耳胆脂瘤手术治疗的方法。方法:回顾性分析2013-06-2016-07期间收治的137耳中耳胆脂瘤患者,分为2个组,A组:75耳,保留部分外耳道后壁上鼓室切开软壁重建;B组:62耳,行经典开放式乳突根治鼓室成形术。观察术中胆脂瘤病变范围及破坏情况,比较术后干耳时间、上皮化时间、眩晕等并发症的发生率及听力改变情况。结果:A组较B组在术后干耳时间、上皮化时间、听力改善上有明显提高,术后眩晕的发生率明显降低,保护了外耳道的解剖生理功能。结论:外耳道后壁部分保留上鼓室切开软壁重建技术有利于彻底清除病变,保护外耳道正常解剖生理,有效地防止了术后上鼓室回缩袋,可降低胆脂瘤的复发率,具有临床实用价值。

Objective：To investigate the surgical treatment of cholesteatoma of the middle ear.Method：A retrospective analysis of patients from June 2013 to July 2016 diagnosed as cholesteatoma.137 ears were divided into A group（retaining part of the external auditory canal posterior wall with epitympanoplasty in soft wall reconstruction for 75 ears）and B group（canal wall down mastoidotympanoplasty for 62 ears）.the extent and damage of cholesteatoma were observed,comparing the time of dry ear and epithelial postoperative,the incidence of complications such as dizziness and hearing changes.Result：compared with B group,the postoperative dry ear time,epithelial time and hearing improvement in the A group were obviously improved,and the incidence of vertigo after operation was decreased,and the anatomical and physiological functions of the external auditory canal were protected.Conclusion：The technique of retaining part of the external auditory canal posterior wall with epitympanoplasty in soft wall reconstruction is conductive to the removal of lesions and normal anatomical and physiological protection to external auditory canal,can prevent the forming of the abstraction pocket effectively and the recurrence of cholesteatoma,has clinical and practical value.