摘要
目的:探讨中耳乳突手术治疗慢性分泌性中耳炎的适应证及治疗效果。方法:回顾分析接受中耳乳突手术治疗30例36耳慢性分泌性中耳炎患者的临床资料。36耳均接受了完壁式(闭合式)乳突-上鼓室切除、鼓室探查术,其中28耳同时行中耳置管术,5耳同时行听骨链成形术。所有病例术中清除的肉芽术后均作病理检验,其中炎性肉芽28耳,胆固醇肉芽肿8耳。结果:中耳置管者于术后1～3月拔除中耳通气管,鼓膜愈合良好。术后所有患耳均有不同程度的听力改善,以语频气导听阈的平均值为标准,听力达到应用水平(语频气导平均听阈30dB以内)的31耳(31/36,86.11%)。鼓室功能曲线检查结果显示,A型27耳(75%),C型8耳(22.22%),B型1耳(2.78%)。术后随访0.5￣3年,除1耳因鼓室积液复发,再次中耳置管外,其余患者症状无复发,主观听力无下降,鼓室功能曲线C型8耳有2耳转为A型。结论:经过各种治疗无效的慢性分泌性中耳炎,应积极采取中耳乳突手术治疗。中耳乳突手术可彻底清除病变,建立鼓室、鼓窦及乳突的通气引流,以防复发。
Objective： To explore the indications and the therapeutic efficacy of mastoid and middle ear surgery in chronic otitis media with effusion. Methods： A retrospective study on 30 patients （36 ears） with chronic secretory otitis media was performed. All the 36 ears underwent intact canal wall masto-atticotomy and exploratory tympanotomy, of them, 28 were performed ventilation tube insertion, and 5 ears had ossicular reconstruction simultaneously. The histopathological examination showed inflammative granuloma （n=28） and cholesterol granuloma （n：8）. Results： The tympanogram results showed that 27 ears were type A, 8 ears were type C, and 1 ear was type B. 27 ears （27/28） were extubated at 1 to 3 months after surgery with healed drums, the other 1 ear had effusion in middle ear recurred and had the ventilation tube to now. Postoperatively followed up for 0.5-3 years, all had hearing improvement, 31 ears （86.11%）had their average speech threshold within 30dB. 2 ears transferred from type C to type A. Conclusion： The mastoid and middle ear surgery should be performed if the chronic secretory otitis midia can not be cured by several kinds of treatment, because of its completely clearance of the diseased tissue, reconstruction of the ventilation function of the tympanic cavity, tympanic sinus and mastoid process, and prevention of recurrence.
出处
《山东大学学报（医学版）》
CAS
北大核心
2005年第8期734-736,共3页
Journal of Shandong University:Health Sciences
关键词
中耳炎
伴渗出液
中耳乳突
外科手术
Otitis media with effusion
Middle ear and mastoid
Surgical procedure, operative
