耳内镜与显微镜下手术治疗中耳胆脂瘤的临床对照研究

A Comparative Clinical Study on the Treatment of Middle Ear Cholestea⁃toma with Ear Endoscopy and Microscopic Surgery

目的研究耳内镜与显微镜下手术治疗耳胆脂瘤的临床效果。方法回顾性选择福建医科大学附属泉州第一医院2016年1月—2021年1月诊断为中耳胆脂瘤的患者106例临床资料,依据不同的手术方法分为两组,各53例,耳内镜下手术治疗者为内镜组,显微镜下手术治疗者为微镜组。比较两组患者术后干耳时间,统计治疗的效果,术后不良症状表现、随访复发情况。结果内镜组患者术后干耳时间与微镜组相比更短,差异有统计学意义(P<0.05)。内镜组患者治疗总有效率98.11%(52/53)高于微镜组86.79%(46/53),差异有统计学意义(P<0.05)。内镜组患者术后不良症状及随访复发率均稍低于微镜组,差异无统计学意义(P>0.05)。结论在耳胆脂瘤患者的手术方案的选择中,耳内镜下手术与显微镜治疗均为手术治疗可以选择的手术方法,术后有效干耳,但均有可能发生术后不良反应及复发,但前者手术术后干耳时间更短,所获得的手术治疗效果更佳。

Objective Clinical effects of endoscopic and microsurgical treatment of ear cholesteatoma.Methods Clini⁃cal data of 106 patients diagnosed with middle ear cholesteatoma admitted to Quanzhou First Hospital Affiliated to Fu⁃jian Medical University from January 2016 to January 2021 were retrospective selected.They were divided into two groups based on different surgical methods,with 53 patients in each group.Those treated with ear endoscopic surgery were called the endoscopic group,and those treated under the microscope were called the microscopic group.The post⁃operative dry ear time was compared between the two groups.The effect of treatment,postoperative adverse symptoms,and follow-up recurrence were collected.Results The postoperative dry ear time of patients in the endoscopy group was shorter than that in the microscope group,and the difference was statistically significant(P<0.05).The total effec⁃tive rate of endoscopic group was 98.11%(52/53)higher than that of microscopic group 86.79%(46/53),the difference was statistically significant(P<0.05).The postoperative adverse symptoms and follow-up recurrence rates of patients in the endoscopy group were slightly lower than those in the microscopic group,the difference was not statistically sig⁃nificant(P>0.05).Conclusion In the selection of surgical options for patients with ear cholesteatoma,ear endoscopic surgery and otomicroscopy are both options for surgical treatment,and postoperative dry ears are effective.However,postoperative adverse reactions and recurrence may occur in both,but the dry ear time is shorter after the former op⁃eration,and the surgical treatment effect obtained is better.