完壁式乳突根治术联合开放式鼓室成型术对胆脂瘤型中耳炎患者听力学指标的影响

Effect of Canal Wall Up Mastoidectmy Combined with Canal Wall Down Tympanoplasty on Audiology Parameters of Patients with Cholesteatoma Otitis Media

目的:探讨完壁式乳突根治术(CWUM)联合开放式鼓室成型术对胆脂瘤型中耳炎患者的治疗效果。方法:选取2019年9月-2021年9月广饶县人民医院收治的80例(80耳)胆脂瘤型中耳炎患者作为研究对象,按照随机数字表法分为两组,各40例(40耳)。对照组采用开放式乳突根治术,观察组采用CWUM联合开放式鼓室成型术。观察至术后3个月,比较两组临床疗效、听力学相关指标、并发症发生情况。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P=0.034)。术前,两组气骨导差、气导听阈水平比较,差异无统计学意义(P>0.05);术后3个月,两组气骨导差、气导听阈水平均低于术前,且观察组低于对照组,差异有统计学意义(P=0.000)。观察组并发症发生率低于对照组,差异有统计学意义(P=0.043)。结论:CWUM联合开放式鼓室成型手术可改善胆脂瘤型中耳炎患者听力学指标,临床疗效显著,术后并发症发生率低,安全可靠,值得临床应用。

Objective:To investigate the treatment effect of canal wall up mastoidectmy(CWUM) combined with canal wall down tympanoplasty in patients with cholesteatoma otitis media.Methods:A total of 80 patients(80 ears) with cholesteatoma otitis media admitted to Guangrao County People's Hospital from September 2019 to September 2021 were selected as the study subjects and divided into two groups according to random number table method,with 40 patients(40 ears) in each group.The control group underwent canal wall down mastoidectmy,while the observation group underwent CWUM combined with canal wall down tympanoplasty.All the patients were observed until 3 months after surgery.Clinical efficacy,audiology-related indicators,and complications were compared between the two groups.Results:The total response rate of treatment in the observation group was higher than that in the control group,and the difference was statistically significant(P=0.034).Before surgery,there was no significant difference in air bone conduction difference and air conduction hearing threshold level between the two groups(P>0.05).At 3 months after surgery,the air bone conduction difference and air conduction hearing threshold level in the two groups were lower than those before surgery,and the observation group was lower than the control group,and the difference was statistically significant(P=0.000).The incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P=0.043).Conclusion:CWUM combined with canal wall down tympanoplasty can improve the audiology-related indicators,has significant clinical efficacy and low incidence of postoperative complications,it is safety and reliable,and worth of clinical promotion.