二次中耳乳突手术

Analysis of 54 Cases of Secondary Surgery for Middle Ear and Mastoid

目的 探讨中耳乳突根治术后不干耳的主要原因及解决办法 ,提高分期鼓室成型术一期手术的干耳率。方法 根据 4 7例二次中耳乳突根治术及 7例分期鼓室成型术Ⅱ期手术的术中所见病变进行总结。结果 肉芽组织增生 4 4例 ,胆脂瘤复发 31例 ,乳突气房残留 2 8例 ,面神经嵴过高 2 4例 ,外耳道口狭窄 2 3例 ,换药不当 19例 ,再次手术后随访 6个月均达到干耳。结论 彻底消除病变组织 ,重点是肉芽及胆脂瘤 ,彻底开放乳突气房 ,磨低面神经嵴至相当水平 ,扩大外耳道口 。

Objective To discusse the mostly causes and resolving ways of non dry ear after radical mastoidectomy. To improve rate of dry cavity after tympanoplasty by stages (Ⅰ period). Methods The operative findings of 47 patients undergoing secondary radical mastoidectomy and 7 patients undergoing tympanoplasty by stages (Ⅱ period) were analyzed. Results There were 44 cases of granulonatous tissue hyperplasia, 31 cases of cholesteatoma recurrence, 28 cases of air cells in the mastoid, 24 cases of high facial nerve ridge, 23 cases of straitness of external aeoustic meatus, 19 cases of unsuitable care of the operated cavity. All patients of secondary surgery were drying in 6 months after operation. Conclusion Thoroughly clearing pathological tissue stressed granulomatous and cholesteatoma, thoroughly opening air cell in the mastoid, lowering the facial nerve ridge, enlarging the external aeoustic meatus, regarding the care of the operated cavity after operation were important measures for reducing non dry after radical mastoidectomy.