开放式鼓室成形或乳突根治术治疗胆脂瘤型和骨疡型中耳炎疗效分析

目的探讨开放式鼓室成形或乳突根治术治疗胆脂瘤型和骨疡型中耳炎的临床疗效。方法42例胆脂瘤型和骨疡型中耳炎,行单纯乳突根治术15例,开放式鼓室成形术27例(含乳突切除术加鼓室成形术Ⅱ型或Ⅲ型)。结果术后6个月～2年随访,单纯乳突根治术15例,获得全部干耳;开放式鼓室成形术27例,22例0.5KHz,1KHz和2KHz纯音平均气骨异差缩小10～30dB,5例与术前无明显变化,23例干耳,2例反复流浓,2例再穿孔,无1例胆脂瘤复发。结论施行开放式鼓室成形或乳突根治术,只要彻底清除乳突中耳病变,乳突轮廓化,重建中耳含气腔,可以消除炎症,防止胆脂瘤复发和提高听力。

Effect analysis of treating chronic suppurative otitis media with cholesteatoma and/or granulation tissue by open tympanoplasty or mastoidectomy

Objective To explore the therapeutic effects of open tympanoplasty or mastoidectomy on chronic suppurative otitis media with cholesteatoma and/or granulation tissue. Methods A mong forty-two cases of chronic suppurative otitis media with cholesteatoma and/or granulation tissue, 15 cases were treated with simple redical mastoidectomy, 27 cases were treated with open tympanoplasty. Results During the follow up of 6 months to 2 years, 15 cases with simple redical mastoidectomy had dry ears. Among 27 cases with open tympanoplasty, the hearing level had been improved from 10 to 30 dB in 22 cases. 23 cases had dry ears, 2 cases hadn’t dry ears, perforation occurred in 2 cases. There wasn’t recurrence of cholesteatoma. Conclusion The open tympanoplasty or mastoidectomy have advantage in retaining physical structure of middle ear, decreasing recurrence of cholesteatoma and improving hearing. The keys of this procedure are the reconctruction of the mastoid cavity thorough removal of lesions and reconstructing an air room in middle ear.