鼓室成形术失败原因的探讨

Causes of the failure of tympanoplasty

目的 :提高临床对耳显微外科鼓室成形术的成功率。 方法 :对 1981年 1月至 1997年 12月耳显微外科鼓室成形术 4 86只耳中 92只耳失败原因 ,进行回顾性分析。 结果 :失败原因归纳为 :中耳炎性病变、咽鼓管功能障碍、手术进路选择不当、手术操作方法不当、听骨链重建不良、鼓膜继发穿孔、术后处理不当等 7个方面。 结论 :针对鼓室成形失败的原因 ,提出预防措施 ,有助于提高鼓室成形术的疗效。

Objectives:To raise the successful rate of microsurgical tympanoplasty. Methods:From Jan.1981 to Dec.1997,microsurgical tympanoplasty was given to 486 ears, and 92 of them failed. The causes of the failure of tympanoplasty were analyzed retrospectively. Results:The failure of tympanoplasty could be concluded as the following nine aspects: inflammatory lesion in the middle ear, Eustanchian tube dysfunction, unhealing of tympanal perforation, healing of tympanal perforation without acoustic improvement, poor reconstruction of ossicula, improper healing of anteroinferior part of myringa, postoperative injury of inner ear, facial nerve injury, improper management after the operation. Conclusions:To raise the therapeutic effects of microsurgical tympanoplasty, precautionary measures were put forward in accordance with the failure causes.