乳突腔填充联合根治术对胆脂瘤型中耳炎患者听力、鼓膜愈合情况的影响

Effect of Mastoid Cavity Filling Combined with Radical Mastoidectomy on Hearing and Tympanic Membrane Healing in Patients with Cholesteatoma Otitis Media

目的:研究乳突腔填充联合根治术对胆脂瘤型中耳炎患者听力、鼓膜愈合情况的影响。方法:选取2013年5月-2018年5月在本院就诊的85例胆脂瘤型中耳炎患者进行回顾性分析,按照手术方式不同分为对照组(n=45)和联合组(n=40)。对照组给予开放式乳突根治术治疗,联合组给予乳突腔填充联合开放式乳突根治术治疗。比较两组听力、术后干耳时间、切口愈合时间、术腔上皮化时间、患者住院时间、鼓膜愈合率、治疗总有效率及并发症发生率。结果:治疗后,两组骨导听力比较,差异无统计学意义(P>0.05)。治疗后,联合组气导听力与气骨导差均低于对照组(P<0.05)。联合组术后干耳、术腔上皮化及住院时间均短于对照组(P<0.05)。联合组鼓膜愈合率为97.50%高于对照组的84.44%(P<0.05)。联合组治疗总有效率为97.50%高于对照组的82.22%(P<0.05)。联合组并发症发生率为5.00%低于对照组的20.00%(P<0.05)。结论:乳突腔填充联合根治术治疗胆脂瘤型中耳炎临床效果显著,能够改善患者听力,提高患者鼓膜愈合率,降低患者并发症。

Objective:To study the effect of mastoid cavity filling combined with radical mastoidectomy on hearing and tympanic membrane healing in patients with cholesteatoma otitis media.Method:A total of 85 patients with cholesteatoma otitis media treated in our hospital from May 2013 to May 2018 were retrospectively analyzed.They were divided into control group(n=45)and combined group(n=40)according to different surgical methods.The control group was treated with open radical mastoidectomy,and the combined group was treated with mastoidectomy combined with mastoidectomy.Hearing,postoperative dry ear time,incision healing time,intraoperative cavity epithelialization time,hospitalization time,tympanic membrane healing rate,total effective rate of treatment and complication rate were compared between the two groups.Result:After treatment,there was no significant difference in bone conduction hearing between the two groups(P>0.05).After treatment,the air conduction hearing and air-bone conduction difference in the combined group were lower than those in the control group(P<0.05).The postoperative dry ear time,epithelialization time and hospitalization time in the combined group were lower than those in the control group(P<0.05).The tympanic membrane healing rate in the combined group was 97.50%higher than 84.44%in the control group(P<0.05).The total effective rate of treatment in the combined group was 97.50%higher than 82.22%in the control group(P<0.05).The incidence of complications in the combined group was 5.00%lower than 20.00%in the control group(P<0.05).Conclusion:Mastoid cavity filling combined with radical mastoidectomy for cholesteatoma otitis media has a significant clinical effect.It can improve patients’hearing,the healing rate of tympanic membrane and reduce complications.