脱细胞真皮填塞开放式乳突根治术腔效果分析

Clinical Observation of Mastoid Obliteration with Acellular Dermal Matrix

目的探讨开放式乳突根治术中采用脱细胞真皮填塞乳突腔的安全性及术后干耳情况。方法回顾性分析2015年1月~2020年1月湖南省人民医院耳鼻咽喉头颈外科收治并行手术治疗的78例中耳胆脂瘤患者的临床资料,所有患者均行开放式乳突根治术,术中使用脱细胞真皮填塞乳突术腔的患者38例为A组,未使用该方法的患者40例为B组,随访时间大于1年;对比两组干耳率、乳突上皮化时间及并发症情况。结果术后干耳时间A组5~9周,B组8~12周;两组患者术后干耳率均达100%,A组乳突腔上皮化时间(6.63±0.94周)短于B组(9.97±1.36周)(t=-11.760,P<0.05),两组术后并发症发生率无明显差异(5.26%vs 5.00%,χ^(2)=0.00,P>0.05)。结论脱细胞真皮填塞开放式乳突根治术腔是安全的,有利于缩短术后乳突术腔的上皮化时间。

Objective To investigate the safety and the state of dry ear of the mastoid cavity using acellular dermal matrix in mastoidectomy canal wall down surgery.Methods A retrospective analysis of 78 cases of patients with middle ear cholesteatoma who underwent mastoidectomy canal wall down surgery collected in January 2015-January 2020 in Hunan province people's hospital otolaryngology head and neck surgery were divided into two groups.There were 38 patients with acellular dermal matrix included in the experimental group(group A),and 40 patients without acellular dermal matrixere were included in the control group(group B),with at least 1 year follow-up.The dry ear rate,epithelialization time and complications were compared between the two groups.Results The dry ear rate of both groups reached 100%with dry ear duration of 5~9 weeks in group A and 8~12 weeks in group B.The epithelialization time in the experimental group was much shorter than that in the control group(6.63±0.94 weeks vs 9.97±1.36 weeks,t=-11.760,P<0.05).There was no significant difference in the incidence of complications(5.26%vs 5.00%,χ^(2)=0.00,P<0.05).Conclusion Mastoid obliteration with acellular dermal matrix in mastoidectomy canal wall down surgery was safe.It could shorten the epithelialization time of the mastoid cavity after mastoidectomy canal wall down surgery.