【摘要】：目的初步探討采用顳肌骨膜瓣轉(zhuǎn)移外耳道后壁重建技術(shù),修復(fù)開放式乳突根治術(shù)后外耳道后壁缺損及開放的乳突腔,提高聽力、重建外耳道解剖及功能、降低膽脂瘤復(fù)發(fā)率的臨床意義。方法將103例膽脂瘤型中耳炎患者分成三組,A組(研究組)45例行開放式乳突根治術(shù),采用顳肌骨膜瓣轉(zhuǎn)移耳道后壁重建技術(shù)同時重建中耳鼓室傳音結(jié)構(gòu);B組(對照組)36例行經(jīng)典的完壁式乳突切除術(shù);C組(對照組)22例行開放式乳突根治術(shù)。A組分別與B、C組在術(shù)后聽力改善率、干耳率、平均干耳時間、膽脂瘤復(fù)發(fā)率及外耳道功能良好率幾方面進行統(tǒng)計學(xué)分析。結(jié)果 A組與B組在術(shù)后聽力改善率、術(shù)后干耳率、術(shù)后平均干耳時間、外耳道功能良好率差異無顯著性,術(shù)后膽脂瘤復(fù)發(fā)率明顯降低,差異有顯著性。A組與C組比較在術(shù)后聽力改善率、術(shù)后平均干耳時間有顯著的提高,外耳道結(jié)構(gòu)及功能得到修復(fù)。結(jié)論軟組織耳道后壁重建并鼓室成形術(shù),在膽脂瘤型中耳炎行乳突切除術(shù)中能使病灶徹底得到清除、降低并發(fā)癥,外耳道原有形態(tài)及功能得以修復(fù),又能改善聽力,且手術(shù)易操作;根據(jù)術(shù)中情況靈活應(yīng)用該手術(shù)方式可顯著降低整組病例術(shù)后膽脂瘤復(fù)發(fā)率;具有臨床應(yīng)用價值。
[Abstract]:Objective to explore the technique of reconstruction of posterior wall of external auditory canal with temporalis periosteum flap transfer, repair the defect of posterior wall of external auditory canal and open mastoid cavity after open mastoidectomy, improve hearing, reconstruct anatomy and function of external auditory canal. Clinical significance of reducing recurrence rate of cholesteatoma. Methods 103 cases of cholesteatoma type otitis media were divided into three groups: group A (study group), 45 patients with open mastoidectomy. Reconstruction of posterior wall of auricular canal with temporalis periosteum flap and reconstruction of tympanic ventricular sound transmission structure in group B (control group) 36 cases were treated with classical wall mastectomy. Group C (control group) 22 cases underwent open mastoidectomy. Group A was treated with open mastoidectomy, respectively. The rate of hearing improvement in group C and group B was improved after operation. The dry ear rate, mean dry ear time, recurrence rate of cholesteatoma and good function of external auditory canal were analyzed statistically. Results there was no significant difference between group A and group B in the improvement rate of hearing, the rate of dry ear, the average dry ear time, the good function of external auditory canal, and the recurrence rate of cholesteatoma after operation. There was significant difference between group A and group C in the improvement rate of hearing, the average dry ear time and the repair of the structure and function of external auditory canal. Conclusion the reconstruction of the posterior wall of soft tissue ear canal and tympanoplasty, mastoidectomy in cholesteatoma type otitis media, can completely clear the focus, reduce complications, repair the original shape and function of external auditory canal, and improve hearing. It is easy to operate and can reduce the recurrence rate of cholesteatoma in the whole group according to the condition of the operation.
【作者單位】： 福建醫(yī)科大學(xué)附屬寧德市醫(yī)院耳鼻咽喉科;
【基金】：寧德市科技局科研立項資助項目(No:寧科20100077)
【分類號】：R739.61

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