耳内镜下中耳胆脂瘤术中应用β-磷酸三钙填塞乳突的治疗效果

Therapeutic effect ofβ-tricalcium phosphate in mastoid cavity obliterationunder endoscope

目的:探讨耳内镜术中使用β-磷酸三钙填塞乳突术腔的治疗效果。方法:将2021年9月至2022年3月收治的中耳胆脂瘤患者60例纳入研究。观察组30例,术中填塞β-磷酸三钙;对照组30例,术中填塞自体组织。2组患者术前、术后行纯音听阈测听,记录500、1000、2000、4000 Hz气导阈值;测量术中乳突填塞完成后及术后外耳道口内1 cm处横截面积。比较2组患者术后干耳时间、听力改变情况、乳突术腔愈合情况差异。结果:观察组患者术后干耳时间为4~14周,平均(9.4±2.7)周;对照组患者术后干耳时间为4~26周,平均(16.0±5.7)周;2组干耳时间差异有统计学意义(P<0.05)。观察组气导听阈较术前改变值为-19~27 dB,平均(6.4±10.7)dB;对照组气导听阈较术前改变值为-9~17 dB,平均(4.7±7.1)dB;2组听力改变差异无统计学意义(P>0.05)。观察组术后外耳道口内1 cm处面积较术中改变值为-5.9~8.2 mm^(2),平均为(-0.6±2.6)mm^(2);对照组术后外耳道口内1 cm处面积较术中改变值为-5.5~5.2 mm^(2),平均为(-0.4±2.3)mm^(2);2组术腔改变差异无统计学意义(P>0.05)。结论:内镜中耳胆脂瘤术中应用β-磷酸三钙填塞乳突术腔对患者听力无不良影响,可缩短术后干耳时间,患者术后愈合良好,值得推广。

Objective To investigate the therapeutic effect ofβ-tricalcium phosphate in mastoid cavity obliteration for middle ear cholesteatoma under endoscope.Methods Sixty patients with middle ear cholesteatoma admitted to our department from September 2021 to March 2022 were included in this study.The observation group(n=30)receivedβ-tricalcium phosphate during mastoid cavity obliteration.The control group(n=30)received autologous tissue during mastoid cavity obliteration.Pure tone audiometry was performed before surgery and after surgery in both groups,and the air conduction thresholds of 500,1000,2000 and 4000 Hz were recorded.The external acoustic meatus cross-sectional area within 1 cm of the external acoustic meatus opening was measured during the operation and after the operation.The differences of postoperative ear drying time,hearing change and mastoid cavity healing were compared between the two groups.Results The duration of postoperative dry ear in the observation group was 2-14 weeks,with an average of(9.4±2.7)weeks,while that in the control group was 4-26 weeks,with an average of(16.0±5.7)weeks.The difference in dry ear time between the two groups was statistically significant(P<0.05).In the observation group,the threshold change was-19-27 dB,with an average of(6.4±10.7)dB,and in the control group,the threshold change was-9-17 dB,with an average of(4.7±7.1)dB.There was no significant difference in hearing change between the two groups(P>0.05).In the observation group,the cross-sectional area of 1 cm inside the ear canal opening was-5.9-8.2 mm^(2),with an average of(-0.6±2.6)mm^(2),and in the control group,the cross-sectional area of 1 cm inside the ear canal opening was-5.5-5.2 mm^(2),with an average of(-0.4±2.3)mm^(2).There was no significant difference in intraoperative cavity changes between the two groups(P>0.05).Conclusion The application ofβ-tricalcium phosphate to fill the mastoid cavity during the operation of endoscopic middle ear cholesteatoma has no adverse effect on the hearing of patients,can shorten the postoperative dry ear time,and results in good postoperative healing,which is worth promoting.