摘要
目的 分析探讨骨或软骨片修复上鼓室外壁,治疗粘连性耳聋耳鸣的效果。方法8例耳鸣和轻度传导耳聋的女性,平均年龄47.4岁(范围30-70岁)。术前听力(取500Hz,1000Hz及2000Hz语言频率均数,下同)有耳鸣耳聋病史平均5年(范围3～10年)。4例术前耳鸣匹配,2例耳鸣频率为500Hz-1000Hz,声强20dB-30dB;另2例为杂声,不能与纯音匹配。术前声导抗:平均为负110毫米水柱(范围负25～负230毫米水柱)。术前听力情况(取500Hz,1000Hz及2000Hz语言频率均数,下同):术前气骨导差15dB HL(范围7-28dBHL),平均气导水平是32dBHL(范围22～47dBHL)。耳内切口,分离外耳道皮瓣。分开鼓环上方的切迹并从切迹中分离出内陷粘连的松弛部鼓膜。分离锤骨颈部与鼓环之间的纤维或骨性粘连,使锤骨颈部前后都出现通气的通道,取小块凿下的耳道碎骨或同种软骨片,填在已凿除鼓环的外侧缘的外耳道壁上,松弛部鼓膜如有穿孔存在,取小块软骨膜内置修补,皮瓣复位在软骨膜外。结果 术后随访平均26.5个月(范围6～72月)。8例耳鸣全部消失。听力全部好转,术后气骨导差平均为4dBHL,与术前相比,缩小19dB。平均气导水平达到10dB以内。声阻抗术前鼓室负压,术后全部变为0或正压10毫米水柱。结论 骨或软骨片修复上鼓室外壁。
Objective Explore effective of bone or cartilage slice blanket graft lateral attic wall reconstruction for tinnitus and deafness by adhesion. Method Eight female with tinnitus and deafness by adhesion were operated with bone or cartilage slice blanket graft lateral attic wall reconstruction. Average 47.4years old(rang30-70). Preoperation pure tone (500,1000,2000Hz average) :air conduction 32.25dBHL (rang 22 - 47dB) ,air- bone gap15.38dB HL (rang 7 - 28dB), implance were all C type, average - 1 l0mmwg ( rang - 25 - 230mmwg) . an incision is made into canal skin adjacent to the lateral attic wall, this flap extends along neck of malleus and until short process was identified. The bonic or fibrous adhesion between neck of malleus and lateral attic wall wre dissected, fore - and - after neck of malleus was ventilated, the bone or cartilage slice blanket graft lateral attic wall, the fascia was graft over and ear canal skin flap was reposited over facia. Results cases were followed up average 26. 5months (rang 6-72months) .Tinnitus were disappeared in all Scases post-operation. Pure tone air- bone gap average 4. 25dBHL, than pre - operation was reduce 19. 5dB. Implance was all 0 or 10mmwg post- operation. Conclusion bone or cartilage slice blanket graft lateral attic wall reconstruction for tinnitus and deafness by adhesion is a minimal invading technique, it can protact a normal meddle ear and auditory ossicles sturcture and made air- bone gap close as well as.
出处
《中华耳科学杂志》
CSCD
2003年第3期43-44,35,共3页
Chinese Journal of Otology
关键词
耳鸣
粘连
鼓室成型
Tinnitus
Adhesion
Tympanoplasty
