中国实用医药
中國實用醫藥
중국실용의약
CHINA PRACTICAL MEDICAL
2014年
16期
19-20
,共2页
中耳胆脂瘤%乳突切除%鼓室成形术%外科手术
中耳膽脂瘤%乳突切除%鼓室成形術%外科手術
중이담지류%유돌절제%고실성형술%외과수술
Middle ear cholesteatoma%Resection%Tympanoplasty%Surgical operation
目的：分析与研究针对中耳胆脂瘤常规治疗所使用的改良乳突根治方案以及鼓室成形手术在医学临床治愈效果的表现。方法本院自2012年10月~2013年9月共收治患有中耳胆脂瘤疾病患者64例,采取改良优化后的乳突根治术以及鼓室成形手术针对患者进行治愈手术,并对患者治疗资料进行详细记录,作为后期临床研究与分析的凭据。结果经过本院完成手术治疗与术后护理的64例患者中63例患者在术后的半年内人工鼓膜在耳内适应生长情况较好,3例患者出现中央穿孔,导致人工听骨外露；根据声音测听结果表明,14例患者术后听力水平没有显著上升,28例患者在言语频率中表现的听力能力明显上升,19例患者的高频范围听力能力减退；根据颞骨CT检测结果表明,64例患者术后中耳含气均为正常,面部神经脊表现相对较低,患者的窦脑膜角后鼓室以及上鼓室前端隐窝没有软组织影像出现；64例患者基本不再出现胆脂瘤萌发病状,外耳道以及乳突腔内上皮恢复较好。结论针对中耳胆脂瘤患者采取改良乳突根治手术以及鼓室成形手术能够最大限度地解决耳道术腔病灶,同时为可能再次复发的胆脂瘤做好预防准备,降低术后中耳细菌感染可能性,提高术后干耳几率,同时改良乳突根治术在手术过程中特别新建听骨链,使得患者听力水平最大保留与提高,具有十分重要的临床治疗价值与意义。
目的：分析與研究針對中耳膽脂瘤常規治療所使用的改良乳突根治方案以及鼓室成形手術在醫學臨床治愈效果的錶現。方法本院自2012年10月~2013年9月共收治患有中耳膽脂瘤疾病患者64例,採取改良優化後的乳突根治術以及鼓室成形手術針對患者進行治愈手術,併對患者治療資料進行詳細記錄,作為後期臨床研究與分析的憑據。結果經過本院完成手術治療與術後護理的64例患者中63例患者在術後的半年內人工鼓膜在耳內適應生長情況較好,3例患者齣現中央穿孔,導緻人工聽骨外露；根據聲音測聽結果錶明,14例患者術後聽力水平沒有顯著上升,28例患者在言語頻率中錶現的聽力能力明顯上升,19例患者的高頻範圍聽力能力減退；根據顳骨CT檢測結果錶明,64例患者術後中耳含氣均為正常,麵部神經脊錶現相對較低,患者的竇腦膜角後鼓室以及上鼓室前耑隱窩沒有軟組織影像齣現；64例患者基本不再齣現膽脂瘤萌髮病狀,外耳道以及乳突腔內上皮恢複較好。結論針對中耳膽脂瘤患者採取改良乳突根治手術以及鼓室成形手術能夠最大限度地解決耳道術腔病竈,同時為可能再次複髮的膽脂瘤做好預防準備,降低術後中耳細菌感染可能性,提高術後榦耳幾率,同時改良乳突根治術在手術過程中特彆新建聽骨鏈,使得患者聽力水平最大保留與提高,具有十分重要的臨床治療價值與意義。
목적：분석여연구침대중이담지류상규치료소사용적개량유돌근치방안이급고실성형수술재의학림상치유효과적표현。방법본원자2012년10월~2013년9월공수치환유중이담지류질병환자64례,채취개량우화후적유돌근치술이급고실성형수술침대환자진행치유수술,병대환자치료자료진행상세기록,작위후기림상연구여분석적빙거。결과경과본원완성수술치료여술후호리적64례환자중63례환자재술후적반년내인공고막재이내괄응생장정황교호,3례환자출현중앙천공,도치인공은골외로；근거성음측은결과표명,14례환자술후은력수평몰유현저상승,28례환자재언어빈솔중표현적은력능력명현상승,19례환자적고빈범위은력능력감퇴；근거섭골CT검측결과표명,64례환자술후중이함기균위정상,면부신경척표현상대교저,환자적두뇌막각후고실이급상고실전단은와몰유연조직영상출현；64례환자기본불재출현담지류맹발병상,외이도이급유돌강내상피회복교호。결론침대중이담지류환자채취개량유돌근치수술이급고실성형수술능구최대한도지해결이도술강병조,동시위가능재차복발적담지류주호예방준비,강저술후중이세균감염가능성,제고술후간이궤솔,동시개량유돌근치술재수술과정중특별신건은골련,사득환자은력수평최대보류여제고,구유십분중요적림상치료개치여의의。
Objective To study and analyze the clinical effect of middle ear cholesteatoma treated by improved radical mastoidectomy and tympanoplasty. Methods From October 2012 to September 2013, there were 64 cases of patients with middle ear cholesteatoma disease in our hospital who were improved radical mastoidectomy and tympanoplasty operation as cure operation, recorded clinical data of patients in detail as the proof of late research and analysis. Results After completed operation therapy and postoperative nursing of 64 cases of patients in 63 patients within half a year after the artificial tympanic membrane in the ear to grow better, 3 patients had central perforation, causing artificial ossicle exserted; according to the tone audiometry results, 14 cases of patients with postoperative hearing level without increased significantly, listening ability 28 patients exhibited in speech frequency rises apparently in the high frequency range, 19 cases of patients with hearing impairment; according to temporal bone CT results, 64 patients of middle ear gas were normal, facial nerve spinal performance is relatively low, not and and attic front recess sinus dural angle of posterior tympanum in patients with soft tissue image appears; 64 patients basic no longer appear cholesteatoma germination conditions, external auditory canal and mastoid cavity epithelium recovered better. Conclusion Improved radical operation such as graph and tympanoplasty operation to maximize the solution cavity lesion of cholesteatoma of the middle ear ear surgery for patients, at the same time as possible doing to prevent recurrence of cholesteatoma otitis media, reduce the possibility of bacterial infection after operation, improve dry ear probability after operation, and improvement in the operation process of special new ossicular chain radical mastectomy the mastoid, the hearing level in patients with maximum retention and improvement, hasgreat clinical value and significance.
