中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2013年
10期
830-833
,共4页
王治强%都基亮%张庆泉%宋莉%孔庆东%王曦%贺庆龙%姜海华%刘大炜
王治彊%都基亮%張慶泉%宋莉%孔慶東%王晞%賀慶龍%薑海華%劉大煒
왕치강%도기량%장경천%송리%공경동%왕희%하경룡%강해화%류대위
中耳通气%中耳%耳疾病
中耳通氣%中耳%耳疾病
중이통기%중이%이질병
Middle ear ventilation%Ear,middle%Ear disease
目的 探讨鼓膜微型管植入术治疗中耳不张的临床疗效.方法 回顾分析26例(28耳)中耳不张的患者,以耳闷为主诉；耳镜检查见鼓膜内陷、光锥散乱或消失、鼓膜苍白无光泽；纯音测听气骨导差＞ 10 dB;声导抗鼓室负压；中耳不张分级Ⅰ～Ⅲ级.患者局麻下行鼓膜微型管置入术,术后随访6 ～12个月.结果 25耳术后耳闷症状消失,其中23耳微型管取出后2周声导抗检查提示鼓室压图由C型恢复为A型,平均听阈下降5 ～20 dB;2耳取管后1个月复发,耳闷症状和中耳负压重新出现.3耳置管失败或耳闷无改善,均为中耳不张Ⅲ级.26例患者取管后2周鼓膜均良好愈合,未出现感染、鼓膜穿孔等并发症.结论 鼓膜微型管置入术能有效解除鼓室负压,缓解耳闷,可用于Ⅰ～Ⅱ级中耳不张的治疗.
目的 探討鼓膜微型管植入術治療中耳不張的臨床療效.方法 迴顧分析26例(28耳)中耳不張的患者,以耳悶為主訴；耳鏡檢查見鼓膜內陷、光錐散亂或消失、鼓膜蒼白無光澤；純音測聽氣骨導差＞ 10 dB;聲導抗鼓室負壓；中耳不張分級Ⅰ～Ⅲ級.患者跼痳下行鼓膜微型管置入術,術後隨訪6 ～12箇月.結果 25耳術後耳悶癥狀消失,其中23耳微型管取齣後2週聲導抗檢查提示鼓室壓圖由C型恢複為A型,平均聽閾下降5 ～20 dB;2耳取管後1箇月複髮,耳悶癥狀和中耳負壓重新齣現.3耳置管失敗或耳悶無改善,均為中耳不張Ⅲ級.26例患者取管後2週鼓膜均良好愈閤,未齣現感染、鼓膜穿孔等併髮癥.結論 鼓膜微型管置入術能有效解除鼓室負壓,緩解耳悶,可用于Ⅰ～Ⅱ級中耳不張的治療.
목적 탐토고막미형관식입술치료중이불장적림상료효.방법 회고분석26례(28이)중이불장적환자,이이민위주소；이경검사견고막내함、광추산란혹소실、고막창백무광택；순음측은기골도차＞ 10 dB;성도항고실부압；중이불장분급Ⅰ～Ⅲ급.환자국마하행고막미형관치입술,술후수방6 ～12개월.결과 25이술후이민증상소실,기중23이미형관취출후2주성도항검사제시고실압도유C형회복위A형,평균은역하강5 ～20 dB;2이취관후1개월복발,이민증상화중이부압중신출현.3이치관실패혹이민무개선,균위중이불장Ⅲ급.26례환자취관후2주고막균량호유합,미출현감염、고막천공등병발증.결론 고막미형관치입술능유효해제고실부압,완해이민,가용우Ⅰ～Ⅱ급중이불장적치료.
Objective To investigate the treatment efficacy of tympanostomy microtube placement surgery for middle ear atelectasis.Methods A retrospective analysis was conducted on 26 patients (28ears) with middle ear atelectasis,who complained fullness or pressure in the ears.Otoscope showed tympanic membrane invagination,scattered or disappeared cone of light,tympanic membrane was pale and dull.The pure tone audiometry air-bone gap ＞ 10 dB.Acoustic immittance showed tympanic negative pressure.All the ears had atelectasis of Ⅰ-Ⅲ grade.Patients were performed tympanic membrane microtube placement under local anesthesia,and were followed up for 6-12 months.Results Twenty-five ears recovered from the fullness after operation,in which,23 ears reverted from type “C” to type “A” in acoustic immittance tests and the pure-tone average (PTA) of hearing thresholds were decreasing from 5 to 20 dB,while 2 ears relapse after removal of the microtube.Three ears with middle ear atelectasis of Ⅲ grade were ineffectiveness.All the 26cases had no complications including middle ear infection,tympanosclerosis,and permanent perforation after removal of the microtubes.Conclusions The placement of tympanostomy microtube can be used to treat middle ear atelectasis,especially to the patients with middle ear atelectasis of Ⅰ-Ⅱ grade as it is effective on elimination of middle ear negative pressure and remission of fullness.
