改良乳突根治术联合鼓室成形术治疗胆脂瘤中耳炎的效果

Effects of modified radical mastoidectomy combined with tympanoplasty on cholesteatoma otitis media

目的:观察改良乳突根治术并鼓室成形术治疗胆脂瘤中耳炎的临床效果。方法:选取60例胆脂瘤中耳炎患者为观察对象,采用随机数字表法将其分为两组各30例,对照组患者行乳突根治术治疗,观察组行改良乳突根治术联合鼓室成形术治疗,比较两组术后1个月临床疗效、并发症发生率及患者听力水平。结果:观察组治疗总有效率为93.33%,明显高于对照组的66.67%,差异有统计学意义(P<0.05);观察组并发症发生率为36.67%,明显低于对照组的90.00%,差异有统计学意义(P<0.05);术前两组患者气骨导差和气导听阈比较,差异无统计学意义(P>0.05),术后观察组患者的气骨导差为(12.31±3.29)dBHL,气导听阈为(27.46±5.19)dBHL,均低于对照组的(19.81±3.54)dBHL和(39.35±6.62)dBHL,差异有统计学意义(P<0.05)。结论:改良乳突根治术联合鼓室成形术治疗胆脂瘤中耳炎能有效降低气骨导差和气导听阈水平,减少术后并发症发生率,提高听力,效果优于乳突根治术治疗。

Objective:To explore clinical effects of modified radical mastoidectomy combined with tympanoplasty in treatment of cholesteatoma otitis media.Methods:60 patients with cholesteatoma otitis media were enrolled in the study.They were divided into two groups according to the random number table method, 30 cases in each.The control group underwent radical mastoidectomy, while the observation group underwent modified radical mastoidectomy combined with tympanoplasty.The clinical efficacy, complication rate and hearing level were compared between the two groups 1 month after the surgery.Results:The total effective rate of the observation group was 93.33%, which was significantly higher than that of the control group (66.67%), and the difference was statistically significant (P<0.05).The incidence of complications in the observation group was 36.67%, which was significantly lower than that of the control group (90.00%), and the difference was statistically significant (P<0.05).There were no significant differences in the air- bone gap and air-conducted hearing threshold between the two groups before the surgery (P>0.05).However, after the surgery, the air-bone gap and air-conducted hearing threshold of the observation group were (12.31±3.29) dBHL and (27.46±5.19) dBHL, respectively, which were lower than the control group of (19.81±3.54) dBHL and (39.35±6.62) dBHL, and the differences were statistically significant (P<0.05).Conclusions:Modified radical mastoidectomy combined with tympanoplasty for the patients with cholesteatoma otitis media can effectively reduce the air-bone gap and air-conducted hearing threshold, decrease the incidence of complications after the surgery, and promote the hearing levels of these patients.Moreover, it is more effective than radical mastoidectomy.