本文選題：慢性化膿性中耳炎 + 中耳膽脂瘤��； 參考：《中華耳科學(xué)雜志》2016年05期

【摘要】：目的探討完橋式乳突切開鼓室成形術(shù)(intact-bridge tympanomastoidectomy,IBM)并用自體骨片重建上鼓室外側(cè)壁的臨床療效。方法對48例(50耳)慢性化膿性中耳炎和中耳膽脂瘤患者采用IBM術(shù)式,清除病變后自體外耳道后壁骨片重建上鼓室外側(cè)壁及聽力重建,觀察鼓膜愈合情況及聽力提高水平,總結(jié)手術(shù)技術(shù)要點和術(shù)后療效。結(jié)果術(shù)后隨訪3-21個月,干耳時間3-14周,平均6.7周;鼓膜穿孔愈合率92%(46/50耳),3耳因術(shù)后感染及1耳膽脂瘤上皮殘留導(dǎo)致鼓膜穿孔不愈,經(jīng)再次手術(shù)愈合。患耳的氣導(dǎo)平均純音聽力(pure tone average,PTA)由術(shù)前53.7±6.9 d BHL提高到術(shù)后36.3±9.1d BHL,氣骨導(dǎo)差(air-bone gap,ABG)由術(shù)前26.4±7.3 d BHL縮小到術(shù)后15.0±4.2d BHL,手術(shù)聽力提高成功率(術(shù)后PTA-ABG≤20d BHL)為72%(36/50耳)。結(jié)論 IBM術(shù)式保留的"骨橋"對重建上鼓室外側(cè)壁的骨片和鼓膜移植物起到支撐作用,結(jié)合上鼓室外側(cè)壁重建保持了中上鼓室含氣腔和正常外耳道后壁形態(tài)結(jié)構(gòu),減少術(shù)后鼓膜內(nèi)陷袋形成,是中耳乳突手術(shù)的理想選擇。
[Abstract]:Objective to investigate the clinical effect of intact-bridge tympanomastoid tympanoplasty and autogenous bone graft in reconstruction of lateral wall of the tympanic wall. Methods 48 cases (50 ears) of chronic suppurative otitis media and cholesteatoma of middle ear were treated with IBM operation. After removing the lesion, the lateral wall and hearing of the tympanic wall were reconstructed by autogenous external auditory meatus, and the healing of tympanic membrane and the improvement of hearing were observed. To summarize the technical points of operation and the effect of operation. Results the follow-up period was 3-21 months, dry ear time was 3-14 weeks (mean 6.7 weeks), the healing rate of tympanic membrane perforation was 92% (46 / 50 ears) due to postoperative infection and residual epithelium of 1 ear cholesteatoma. The mean pure tone hearing (pure tone) of the affected ears increased from 53.7 鹵6.9 d before operation to 36.3 鹵9.1 d after operation, and the air-bone gap decreased from 26.4 鹵7.3 d before operation to 15.0 鹵4.2 d after operation. The successful rate of hearing improvement (PTA-ABG 鈮，

本文編號：2058492