自体移植外耳道后壁重建联合鼓室成形术治疗中耳胆脂瘤的效果观察

Clinical Observation of Autologous Transplantation and Reconstruction of Posterior Wall in External Auditory Canal Combined with Tympanoplasty in Treatment of Patients with Middle Ear Cholesteatoma

目的探讨自体移植外耳道后壁重建联合鼓室成形术在中耳胆脂瘤治疗中的临床效果及对听力的影响。方法选取2014年4月—2016年3月收治的中耳胆脂瘤169例,根据手术方式分为观察组85例和对照组84例。观察组行自体移植外耳道后壁重建联合鼓室成形术治疗,对照组行经典完壁式乳突切除术鼓室成形术。治疗后随访1年,观察比较两组临床疗效、听力评价指标的变化及复发率、并发症发生情况。结果观察组总有效率高于对照组,术后干耳持续时间短于对照组,气导、骨导和气骨导差小于对照组,复发率和并发症发生率低于对照组(P<0.05)。结论自体移植外耳道后壁重建联合鼓室成形术治疗中耳胆脂瘤具有良好的临床效果,可有效提高听力,降低复发率和并发症发生率。

Objective To investigate clinical effect of autologous transplantation and reconstruction of posterior wall in external auditory canal combined with tympanoplasty in treatment of patients with middle ear cholesteatoma and its effect on audition. Methods A total of 169 patients with middle ear cholesteatoma admitted during April 2014 and March 2016 were divided into observation group( n = 85) and control group( n = 84) according to operative methods.Observation group received autologous transplantation and reconstruction of posterior wall in external auditory canal combined with tympanoplasty,while control group was given the classical fare-thee-well mastoidectomy and tympanoplasty.All the patients were followed up for one year after treatment,and clinical effects,changes of auditory evaluation indexes and incidence rates of recurrence and complications were observed and compared in two groups. Results In observation group,the total effective rate was significantly higher,and duration of dry ear was significantly shorter,and values of air conduction,bone conduction and air-bone conduction were significantly lower,and incidence rates of recurrence and complication were significantly lower than those in control group( P < 0. 05). Conclusion Autologous transplantation and reconstruction of posterior wall in external auditory canal combined with tympanoplasty in treatment of patients with middle ear cholesteatoma may achieve well curative effect,improve auditory and reduce incidence rates of recurrence and complications.