中华显微外科杂志
中華顯微外科雜誌
중화현미외과잡지
Chinese Journal of Microsurgery
2010年
4期
290-292
,共3页
于锋%龚辉成%张浩亮%谭国杰%黄羽张
于鋒%龔輝成%張浩亮%譚國傑%黃羽張
우봉%공휘성%장호량%담국걸%황우장
胆脂瘤%鼓室成形术%保留骨桥%中耳炎%耳显微手术
膽脂瘤%鼓室成形術%保留骨橋%中耳炎%耳顯微手術
담지류%고실성형술%보류골교%중이염%이현미수술
Cholesteatoma%Tympanoplasty%Intact-bridge%Otitismedis%Otomicrosurgical operation
目的 探讨保留部分骨桥的鼓室显微成形术在治疗胆脂瘤型中耳炎临床效果、影响预后的因素及综合治疗的地位.方法 选择33例43耳胆脂瘤型中耳炎行保留部分骨桥的鼓室成形术,并对手术方法、技术要点、术后出现问题和疗效进行分析.结果 随访18～72个月,术后3～4个月以后采用内镜显像系统或手术显微镜观察,可见43耳乳突及鼓窦区为上皮覆盖,乳突腔上皮化良好,中耳与乳突腔分隔良好,移植鼓膜愈合39耳(39/43,90.7%),2耳分别在术后4个月、6个月因感染发生穿孔,经抗炎治疗及烧灼治疗后痊愈,1耳上鼓室鼓窦处肉芽组织生长,有少量脓液,经抗炎换药处理后15周干耳,1耳术腔反复流脓,经抗炎及物理治疗,24周后干耳.术后听力检测结果显示语言频率气导术后平均值较术前提高(16.8±6.8)dB HL,听力改善为:79.1%(34/43).结论 选择适当的手术适应证,围术期的综合治疗,手术中病灶清理彻底,保留部分骨桥的鼓室一期成形术在治疗胆脂瘤型中耳炎临床效果良好.
目的 探討保留部分骨橋的鼓室顯微成形術在治療膽脂瘤型中耳炎臨床效果、影響預後的因素及綜閤治療的地位.方法 選擇33例43耳膽脂瘤型中耳炎行保留部分骨橋的鼓室成形術,併對手術方法、技術要點、術後齣現問題和療效進行分析.結果 隨訪18～72箇月,術後3～4箇月以後採用內鏡顯像繫統或手術顯微鏡觀察,可見43耳乳突及鼓竇區為上皮覆蓋,乳突腔上皮化良好,中耳與乳突腔分隔良好,移植鼓膜愈閤39耳(39/43,90.7%),2耳分彆在術後4箇月、6箇月因感染髮生穿孔,經抗炎治療及燒灼治療後痊愈,1耳上鼓室鼓竇處肉芽組織生長,有少量膿液,經抗炎換藥處理後15週榦耳,1耳術腔反複流膿,經抗炎及物理治療,24週後榦耳.術後聽力檢測結果顯示語言頻率氣導術後平均值較術前提高(16.8±6.8)dB HL,聽力改善為:79.1%(34/43).結論 選擇適噹的手術適應證,圍術期的綜閤治療,手術中病竈清理徹底,保留部分骨橋的鼓室一期成形術在治療膽脂瘤型中耳炎臨床效果良好.
목적 탐토보류부분골교적고실현미성형술재치료담지류형중이염림상효과、영향예후적인소급종합치료적지위.방법 선택33례43이담지류형중이염행보류부분골교적고실성형술,병대수술방법、기술요점、술후출현문제화료효진행분석.결과 수방18～72개월,술후3～4개월이후채용내경현상계통혹수술현미경관찰,가견43이유돌급고두구위상피복개,유돌강상피화량호,중이여유돌강분격량호,이식고막유합39이(39/43,90.7%),2이분별재술후4개월、6개월인감염발생천공,경항염치료급소작치료후전유,1이상고실고두처육아조직생장,유소량농액,경항염환약처리후15주간이,1이술강반복류농,경항염급물리치료,24주후간이.술후은력검측결과현시어언빈솔기도술후평균치교술전제고(16.8±6.8)dB HL,은력개선위:79.1%(34/43).결론 선택괄당적수술괄응증,위술기적종합치료,수술중병조청리철저,보류부분골교적고실일기성형술재치료담지류형중이염림상효과량호.
Objective To discuss with micro-tympanoplastic operation with osteo retention on treating cholesteatomatous otitismedis. Methods Choose 33 cases cholesteatomatous otitis medis patients who toke the tympanoplastic with osteo retention operation,then analyze the postulate and method of the operation, curative effect and complication after operation. Results Follow up with those patients by 12-72 months, and when 3-4 months after operation we endoscopiced the ears, could see that 43 cases of patients ear mastoid process and tympanic sinus were covered with epithelium, those mastoid cavity were well epithelial metaplasia;and the middle ear was separate from mastoid cavity; 39 cases patient of transplant eardrums are heal up (39/43, 90.7%). 2 cases have perforation of the tympanic membrane toke place after 4 months and 6 months with the operation, and it will heal up by anti-inflammatory drug and laser burning, 1 case had tympanic sinus hyperplasia with granulation tissue, and also had grassery juice; after taken anti-inflammatory drug and change bandage for 15 weeks, the symptom disappear. 1 case had grassery juice of operation cavity, after taking anti-inflammatory drug and physiotherapy, the symptom disappear in 24 weeks. After operation the pure tone audiometry shows that air conduction raise (16.8±6.8) dB HL, hearing raise up to:79.1%(34/43). Conclusion Base on right indication of operation choose, taken combined therapy of ambi-operation period, focus of infection are thoroughly cleaning up. Tympanoplastic with osteo retention are treating well with patients of cholesteatomatous otitismedis.
