CAJ | 학술논문

目的：探讨慢性中耳乳突炎性疾病的不同显微手术方式的疗效。方法2009年1月～2013年10对110例慢性中耳乳突炎性病变，包括中耳胆脂瘤和慢性化脓性中耳炎，根据病变范围显微镜下分别施行完壁式乳突根治或同时鼓室成形术和开放式乳突根治术，观察术后干耳恢复情况、并发症、复发以及术后听力改善程度等。结果完壁式乳突根治术51例，其中46例同时行鼓室成形术，6例行二期人工假体植入术。2例中耳胆脂瘤术后1年复发，第2次行开放式手术。术后听力提高＞25 dB 27例，＞15 dB 16例，听力减退1例。开放式乳突根治术59例，其中31例行小鼓室成形术。1例开放式手术后不干耳，换药2个月后获得干耳，其余均获得干耳。术后听力提高＞15 dB 5例，听力减退3例，余听力无改善。结论根据病例选择适当的术式可以获得满意的临床疗效。
목적：탐토만성중이유돌염성질병적불동현미수술방식적료효。방법2009년1월～2013년10대110례만성중이유돌염성병변，포괄중이담지류화만성화농성중이염，근거병변범위현미경하분별시행완벽식유돌근치혹동시고실성형술화개방식유돌근치술，관찰술후간이회복정황、병발증、복발이급술후은력개선정도등。결과완벽식유돌근치술51례，기중46례동시행고실성형술，6례행이기인공가체식입술。2례중이담지류술후1년복발，제2차행개방식수술。술후은력제고＞25 dB 27례，＞15 dB 16례，은력감퇴1례。개방식유돌근치술59례，기중31례행소고실성형술。1례개방식수술후불간이，환약2개월후획득간이，기여균획득간이。술후은력제고＞15 dB 5례，은력감퇴3례，여은력무개선。결론근거병례선택괄당적술식가이획득만의적림상료효。
Objective To study the curative effects of microscopic surgery for inflammatory lesions in the middle ear and mastoid by using different surgical procedures . Methods There were 110 cases of inflammatory lesions in the middle ear and mastoid from January 2009 to October 2013, including middle ear cholesteatoma and chronic suppurative otitis media .According to the scope of the lesions , either canal wall up mastoidectomy with or without tympanoplasty or open mastoidotympanectomy was carried out . Postoperative ear recovery , complications , recurrence , and hearing improvement were observed . Results The canal wall up mastoidectomy was performed in 51 cases, 46 of which received tympanoplasty simultaneously and 6 of which underwent a secondary artificial prosthesis implantation .Two patients with middle ear cholesteatoma experienced recurrence 1 year after surgery , and were given a secondary open operation .Postoperatively, hearing improvement was achieved >25 dB in 27 cases, >15 dB in 16 cases, and hearing loss was seen in 1 case.There were 59 cases of open mastoidectomy , including 31 cases of small tympanic cavity plasty .After open surgery, dry ear was not achieved in 1 case, which was cured after 2 months of dressing changes .The dry ear was achieved in all the remaining cases, with hearing improvement >15 dB in 3 cases and hearing loss in 3 cases. Conclusion According to different lesions in the middle ear and mastoid , different operative methods can be used to obtain satisfactory clinical curative effects .