摘要
目的介绍完壁式鼓室成形术治疗慢性化脓性中耳炎的的手术体会。方法回顾性分析96完壁式鼓室成形术治疗慢性化脓性中耳炎的临床资料,术中注意上鼓室外侧壁盾板的完整,清除病灶保护粘膜,建立咽鼓管、鼓室、鼓窦、乳突的通气引流系统。结果术前纯音听力测试0.5、1.0、2.0、4.0kHz语言频率区听阈气骨导差的平均值0—10dB为0耳(0%),11-20dB为4耳(4.17%),21—30dB为29耳(30.2%),31—40dB为46耳(47.9%),大于40dB为17耳(17.7%),平均气导为(54.1±6.5)dB,平均骨导为(13.6±7.6)dB;术后3月纯音听力测试,0.5、1.0、2.0、4.0kHz语言频率区听阈气骨导差的平均值0一lOdB为25耳(26.0%),11-20dB为46耳(47.9%),21—30dB为19耳(19.8%),31—40dB为6耳(6_3%),大于40dB为0耳O%),平均气导为(38.1±7.9)dB,平均骨导为(12.5±6.3)dB。术后8月以上(平均间隔时间为11个月)纯音听力测试的情况是0—10dB为22耳(22.9%),11-20dB为41耳(42.7%),21-30dB为24耳(25%),31-40dB为9耳(9.3%),大于40dB为0耳0%),平均气导为(41.2±8.4)dB,平均骨导为(12.6±7.6)dB。术后8个月-3年随访中行颞骨CT扫描(平均间隔时间为11个月),96耳中75耳乳突鼓窦保持气化(78.1%),21耳乳突鼓窦软组织影充填(21.9%)。结论完壁式鼓室成形术治疗慢性化脓性中耳炎可取得满意疗效,遵循个体化原则建立合理的中耳通气引流系统是手术的关键。
Objective To introduce the experience of the intact canal wall tympanoplasty in chronic suppurative otitis media. Methods Clinical data of 96 cases of the intact canal wall tympanoplasty for treating chronic suppurative otitis media was retrospectively reviewed. During the operation, the outside wall of attic should be keeped intact, lesions should be re- moved, mucosa should be protected, and the air drainage system of eustachian tube,middle ear,sinus and mastoid shoulded be established. Results The preoperative pure tone audiometry (the average heating threshold at 0.5,1.0,2.0,4.0 kHz HL) of the mean air bone gap was 0 - 10dB in 0 ears(0%), 11 -20 dB in 4 ears (4.17%) ,21- 30 dB is 29 ears (30.2%),31-40 dB is46 ears(47.9% ) ,over 40 dB in 17 ears( 17.7% ).The postoperative pure tone audiometry (the average heating threshold at 0.5,1.0, 2.0,4.0 kHz HL) of the mean air bone gap was 0 - 10dB in 22 ears(22.9%), 11 -20 dB in 41 ears (42.7%), 21- 30 dB is 24 ears(25% ),over 30 dB in 9 ears(9.3% ).Temporal bone CT showed: the proportion of the ear drums mastoid antrum regasifica- tion is 78.1%,and the ear drums mastoid antrum tissue pack is 29.1%. Conclusion The curative effect of the intact canal wall tympanoplasty in patients with chronic suppurative otitis media is satisfactory. The key of the operation is setting up reason- able middle ear ventilation drainage system fallowing the principle of individualization.
出处
《中华耳科学杂志》
CSCD
北大核心
2013年第4期561-564,共4页
Chinese Journal of Otology