改良乳突根治及鼓室成形术治疗中耳胆脂瘤临床分析

Clinical Analysis of Modified Radical Mastoidectomy and Myringoplasty in Middle Ear Cholesteatoma

目的:探究中耳胆脂瘤患者在使用改良乳突根治及鼓室成形术治疗后的治疗效果。方法:选取2012年6月-2015年6月本院收治的75例中耳胆脂瘤患者,均采用改良乳突根治及鼓室成形术治疗。观察该治疗方案对患者的治疗效果、术后恢复、并发症发生率及复发情况。结果:治疗总有效率为97.33%,干耳时间平均(3.26±0.33)周,上皮化时间平均(7.25±0.71)周。患者术后气导平均听阀(32.45±3.46)db HL显著低于术前(55.34±5.36)db HL,差异有统计学意义(t=31.072,P=0.00)。术后气骨导差为(25.34±2.33)db HL,显著低于术前的(35.45±3.36)db HL,差异有统计学意义(t=21.413,P=0.00)。仅有1例发生并发症,发生率为1.33%,无一例患者在2年内复发。结论:将改良乳突根治及鼓室成形术应用于中耳胆脂瘤患者后,患者术后并发症发生率低,且治疗效果显著,对干耳时间、上皮化时间、气导平均听阀、气骨导差改善明显,此方法值得应用与推广。

Objective：To discuss the therapeutic effect of modified radical mastoidectomy and myringoplasty in middle ear cholesteatoma.Method：A total of 75 cases with middle ear cholesteatoma undergoing the modified radical mastoidectomy and myringoplasty in our hospital from June 2012 to June 2015 were selected.The therapeutic effect,postoperative recovery,incidence rate of complication and recurrence rate were observed.Result：The total effective rate was 97.33%,the average dry ear time was（3.26±0.33）weeks and epithelization time was（7.25±0.71）weeks.The average audible thresholds after surgery（32.45±3.46）db HL was lower than that before surgery（55.34±5.36）db HL,the difference was statistically significant（t=31.072,P=0.00）.The air-bone gap after surgery（35.45±3.36）db HL was lower than that before surgery（25.34±2.33）db HL,the difference was statistically significant（t=21.413,P=0.00）.There was just one recurrent case（1.33%）and none recurrent case within 2 years.Conclusion：The modified radical mastoidectomy and myringoplasty can remarkably reduce the incidence rate of complications,shorten the dry ear time and epithelization time,reduce the audible threshold and air-bone gap.