CAJ | 학술논문

目的探讨活动期慢性化脓性中耳炎Ⅰ期鼓室成形术的可行性和疗效.方法 48例活动期(48耳)慢性化脓性中耳炎患者(胆脂瘤型31例,骨疡型17例)在彻底清除病变(经典或改良乳突根治术)同时进行Wullstein Ⅱ型和Ⅲ型鼓室成形术.结果全部4～10周,平均7周干耳.术后1年纯音听力测试:气骨导差10 dB以内者11例,15～20 dB者25例,25～30 dB者9例,无变化甚至更差者3例.结论慢性化脓性中耳炎活动期不是鼓室成形术的绝对禁忌证.术中彻底清除所有病变、重建乳突-鼓室-咽鼓管引流通气系统后,进行Wullstein Ⅲ型+乳突腔填充+耳甲腔成形术是可取的方法,同时咽鼓管是否通畅是手术成败的主要原因.
목적 탐토활동기만성화농성중이염Ⅰ기고실성형술적가행성화료효.방법 48례활동기(48이)만성화농성중이염환자(담지류형31례,골양형17례)재철저청제병변(경전혹개량유돌근치술)동시진행Wullstein Ⅱ형화Ⅲ형고실성형술.결과 전부4～10주,평균7주간이.술후1년순음은력측시:기골도차10 dB이내자11례,15～20 dB자25례,25～30 dB자9례,무변화심지경차자3례.결론 만성화농성중이염활동기불시고실성형술적절대금기증.술중철저청제소유병변、중건유돌-고실-인고관인류통기계통후,진행Wullstein Ⅲ형+유돌강전충+이갑강성형술시가취적방법,동시인고관시부통창시수술성패적주요원인.
Objective To investigate the possibility and surgical effect of simultaneous tympanoplasty to chronic suppurative otitis media in the period of infection. Methods Forty-eight cases (48 ears) with chronic suppurative otitis media in the period of infection (31 with cholesteatoma, 17 with caries) were underwent simultaneous Wullstein Ⅱ and Ⅲ tympanoplasty on the complete elimination of the lesions (typical or modified mastoidectomy). Results All eases had dry ears within 4-10 weeks with average of 7 weeks. The air-bone gap within 10 dB was in 11 eases, 15 to 20 dB in 25 cases, 25 to 30 dB in 9 eases, no change or worse in 3 eases. Conclusions Infection is not the absolute eontraindication to the tympanoplasty in treating chronic suppurative otitis media, Wullstein Ⅲ tympanoplasty plus mastoid cavity obliteration and eonchaplasty is a suitable choice to treating chronic suppurative otitis media on the complete elimination of lesions and reconstruction of the ventilation system among mastoid cavity, tympanum and eustachian. The malfunction of eustachian is the main eanse to failure of surgery.