耳内镜不同术式治疗HoltⅢ期外耳道胆脂瘤的临床分析

Clinical Analysis of Different Surgical Methods of Otoscope in the Treatment of HoltⅢ External Auditory Canal Cholesteatoma

目的探讨耳内镜下不同术式治疗HoltⅢ期外耳道胆脂瘤的临床效果。方法选择平邑县人民医院2016年2月-2018年12月收治的78例HoltⅢ期外耳道胆脂瘤患者,随机分为对照组及研究组,研究组采用耳内镜外耳道胆脂瘤切除术,对照组采用耳内镜胆脂瘤切除术+鼓室成形术+乳突切除术,比较两组患者临床疗效,术后听力恢复情况及并发症发生情况。结果研究组临床总有效率为94.9%,对照组临床总有效率为92.3%,两组临床有效率差异无统计学意义(χ^2=0.214,P=0.644)。骨导及气导听阈对照组术前分别为(16.2±3.8)dB及(50.4±6.9)dB,研究组术前分别为(16.1±3.7)dB及(49.7±6.7)dB,对照组术后分别为(10.6±2.5)dB及(26.4±4.2)dB,研究组分别为(8.2±2.2)dB和(17.9±3.8)dB,两组术前骨导听阈及气导听阈,差异无统计学意义(P>0.05),术后两组患者骨导听阈及气导听阈均明显下降,差异有统计学意义(P<0.05),治疗后研究组骨导听阈及气导听阈低于对照组,差异有统计学意义(P<0.05),研究组并发症发生率为5.1%,对照组并发症发生率为20.5%,研究组并发症发生率低于对照组,差异有统计学意义(χ^2=4.129,P=0.042)。结论HoltⅢ期外耳道胆脂瘤耳内镜下单纯胆脂瘤切除术能够降低手术风险,减少并发症的发生,改善术后听力恢复情况,具有较好的临床效果。

Objective To investigate the clinical effects of different surgical methods for the treatment of HoltⅢexternal auditory canal cholesteatoma under otoscope.Methods A total of 78 patients with Holt Stage III external auditory canal cholesteatoma who were ad-mitted to Pingyi County People’s Hospital from February 2016 to December 2018 were randomly divided into control group and study group.The study group underwent endoscopic external auditory canal cholesteatoma resection.In the control group,endoscopic cholesteatoma resection+tympanoplasty+mastoidectomy were used to compare the clinical efficacy,postoperative hearing recovery and complications of the two groups.Results The total clinical effective rate of the study group was 94.9%,and the total clinical effec-tive rate of the control group was 92.3%.There was no statistically significant difference in the clinical effective rate between the two groups(χ^2=0.214,P=0.644).The bone conduction and air conduction hearing thresholds in the control group were(16.2±3.8)dB and(50.4±6.9)dB before operation,(16.1±3.7)dB and(49.7±6.7)dB in the study group,and(10.6±2.5)dB and(26.4±4.2)dB in the control group after operation,the study group were(8.2±2.2)dB and(17.9±3.8)dB,respectively.There was no statistically significant difference in bone conduction hearing threshold and air conduction hearing threshold between the two groups(P>0.05).Both were significantly decreased,the difference was statistically significant(P<0.05).After treatment,the bone conduction hearing threshold and air conduction hearing threshold in the study group were lower than those in the control group,the difference was statistically significant(P<0.05).The complication rate in the study group was 5.1%,and the complication rate in the control group was 20.5%.The incidence of complications in the study group was lower than that in the control group,the difference was statistically significant(χ^2=4.129,P=0.042).Conclusion HoltⅢstage external auditory canal cholesteatoma under otoscope alone cholesteatoma resection can re duce the risk of surgery,reduce the occurrence of complications,improve postoperative hearing recovery,and has a good clinical effect.