乳突根治术后鼓室自然成形初探

目的探讨部分慢性中耳炎乳突根治术后鼓室自然成彤病例的发生机制和临床应用的可行性。方法同顾性分析笔者1987年5月至2006年4月所做46例乳突根治手术及术后21例发生鼓室自然成形病例的资料，研究其病理特点、手术操作特点及术后换药特点等与术后鼓膜再生愈合现象的关系。结果46洲乳突根治术病例中有21例（46％）术后发生鼓膜再生愈合现象。其中听力完全恢复2例，明显改善6例，部分改善11例，无改善2例。结论如严格按手术要求，保护残存鼓膜及中耳传音结构，术后合理用药，胆脂瘤型和混合型部分患者鼓膜常可发生自然再生愈合现象，听力也有明显改善。

Study on Natural Shaping of Cavum Tympani after Radical Mastoidectomy

Objective To study the occurrence mechanism and the clinical practice feasibility of cases of cavum tympani natural shaping after partial radical mastoidectomy.Methods A total of 18 radical mastoidectomy cases between June,1996 and June,2006 were analyzed,and the relationship between pathological characteristics,operation-performing features as well as dressing change after the operation and the phenomenon of tympanic membrane regeneration and healing were studied.Results In 21 out of 46 cases,tympanic membrane was regenerated and healed after the operation,among which hearing recovered completely in 2 cases,noticeably improved in 6 cases,partly improved in 11 cases and not improved at all in 2 cases.Conclusion Attention paid to the protection of remnant tympanic membrane and middle ear biography tone structure in radical mastoidectomy,together with rational use of medication after the operation,can generally contribute to the natural regeneration and healing of the cavum tympani and obvious improvement of hearing.