摘要
目的:探讨胆脂瘤并发迷路瘘管患者的临床特点和治疗方法。方法:胆脂瘤并发迷路瘘管23例(6.6%)患者中,15例行开放式乳突根治术加鼓室成形术,6例行开放式乳突根治术,2例行乳突再根治术。结果:术后平均随访2年,21例干耳,22例眩晕消失,术后平均骨导听力无明显变化。结论:胆脂瘤中耳炎常并发迷路瘘管,术前尚无可靠确诊方法,颞骨高分辨CT对较大瘘管检出率高,最后确诊靠手术探查;对瘘管区病变的处理应彻底清除病变,修补瘘孔。
Objective:To describe the clinical presentation and surgical management of patients with labyrinthine fistula caused by cholesteatoma.Method:Retrospective study of the clinical presentation, surgical technique and hearing outcomes based on 350 cases of chronic otitis media with cholesteatoma was carried out.Twenty three patients (6.6%) with labyrinthine fistula were found , in 9 ears (39.1%) the preoperative pure tone average for bone conduction was greater than normal, including 2 cases of anacusis .Subjective vertigo or dizziness occured in 11 patients (47.8%), the fisrula test was positive in 5 patients (21.7%). Preoperative high resolution computed tomography (HRCT) scans were performed on all patients and 13 patients (57%) were detected to be with labqrinthine fistula in imaging.During the operation we found the lateral semicircular canal was the most commonly affected site (20/23) ,at the same time dehiscence of the facial canal was observed in 8 patients.Result:The patients were followed-up for an averge time of 2 years , dizziness disappeared completely in 22 cases and there were no significant changes in their bone conduction thresholds.Conclusion:Labyrinthine fistulae are usually caused by cholesteatoma.There are no reliable methods at present for preoperative diagnosis HRCT is useful but its limitations should also be recognized.The verification of a labyrinthine fistula can be definitively established only at the time of surgery . Completely remove the cholesteatoma matrix can be the treatment of choice in these cases.
出处
《临床耳鼻咽喉科杂志》
CAS
CSCD
北大核心
2005年第13期592-593,共2页
Journal of Clinical Otorhinolaryngology
关键词
迷路瘘管
胆脂瘤
中耳
Labyrinthine fistula
Cholesteatoma
Middle ear
