耳内镜下处理先天性中耳胆脂瘤的临床疗效分析

Clinical Effect Analysis of Congenital Cholesteatoma of Middle Ear Treated by Otoendoscopy

目的:分析耳内镜下处理先天性中耳胆脂瘤的临床疗效,为先天性中耳胆脂瘤临床治疗提供有益指导。方法:对笔者所在医院2017年5月-2019年5月收治的30例先天性中耳胆脂瘤患者的临床资料进行回顾性分析,掌握先天性中耳胆脂瘤耳内镜下处理方法,观察临床疗效、听力功能改善情况、并发症发生情况及术后复发情况。结果:患者临床治疗总有效率为93.33%;术后患者气骨导差值为(18.24±2.35)dB,气导听阈值为(26.96±6.41)HL,均低于术前的(29.44±2.72)dB、(43.65±6.74)HL,差异均有统计学意义(P<0.05);术后随访,未见面瘫、脑脊液漏、味觉异常病例,外耳道感染1例,感音神经性听力下降1例,并发症发生率为6.67%(2/30),经治疗均恢复;术后1年未见病变复发病例。结论:在先天性中耳胆脂瘤治疗中,耳内镜手术治疗安全、有效,利于患者疾病康复。

Objective:To analyze the clinical efficacy of treating congenital cholesteatoma of the middle ear under otoendoscopy,and to provide beneficial guidance for the clinical treatment of congenital cholesteatoma of the middle ear.Method:The clinical data of 30 patients with congenital cholesteatoma in the middle ear admitted to the author’s hospital from May 2017 to May 2019 were analyzed retrospectively to master the treatment methods under otoscope for congenital cholesteatoma of the middle ear.The clinical efficacy,improvement of hearing function,complications and postoperative recurrence were observed.Result:The total effective rate was 93.33%.After the operation,the difference between the patients’airbone conduction was(18.24±2.35)dB,and the threshold of airconduction hearing was(26.96±6.41)HL,both were lower than(29.44±2.72)dB and(43.65±6.74)HL before the operation,the differences were statistically significant(P<0.05).Postoperative follow-up revealed no facial paralysis,cerebrospinal fluid leakage,or taste abnormalities,1 case of external auditory canal infection,1 case of sensorineural hearing loss,and the incidence of complications was 6.67%(2/30).All cases were recovered after treatment.There was no recurrence one year after operation.Conclusion:In the treatment of congenital cholesteatoma of the middle ear,endoscopic surgery is safe and effective,which is beneficial to patients’rehabilitation.