摘要
目的探讨慢性中耳炎并发迷路瘘管的手术处置方法及临床效果。方法选择2009年1月～2012年5月在长沙唯尔耳鼻咽喉专科医院耳鼻咽喉科治疗的慢性中耳炎并发迷路瘘管患者62例,行瘘管检查与颞骨高分辨率CT(HRCT)扫描,于全麻下行开放式乳突根治+听力重建术。观察手术效果及并发症情况。结果 55例病变为水平半规管瘘,5例为上半规管瘘,2例同时存在水平和上半规管病变,全部病例均Ⅰ期修补成功。术后(8.7±2.2)d眩晕消失或改善,术后(42.8±6.0)d干耳,术腔上皮化;53例(85.48%)患者术后听力提高,26例(41.93%)语频气导听力提高>15 dB。术后随访(2.1±0.6)年,未见眩晕复发。结论开放式乳突根治加听力重建术可能是治疗慢性中耳炎并发迷路瘘管比较优化的方案,对于瘘管区域病变的处理应综合考虑,对瘘管大、病变重者应行二期手术。
Objectives To explore the surgical method and clinical effect of treating chronic otitis media combined with labyrinth fistula.Methods 62 cases of unilateral chronic otitis media combined with labyrinth fistula in Weier Specialized Otorhinolaryngologic Hospital in Changsha City from January 2009 to May 2012 were selected,and were given mastoid radical surgery of open type with hearing reconstruction in general anesthesia after fistula check and HRCT scan.The operation effect and complications situation were observed.Results 55 cases of horizontal semicircular canal fistula were found,5 cases of upper semicircular canal fistula were found,2 cases of horizontal and upper semicircular canal fistula were found,all patients were successfully repaired by Ⅰ stage surgery.Vertigo symptom was found improved or disappeared（8.7 ±2.2） days after the surgery,and ears were dry（42.8 ±6.0） days after the surgery, then surgery cavity was found epithelized.Listening were found improved in 53 patients（85.48%） and more than 15 dB of language conductance hearing were found improved in 26 cases（41.93%）.There was no recurrence of vertigo during（2.1±0.6） years＇ follow-up.Conclusion It may be an optimized scheme of treating chronic otitis media combined with labyrinth fistula by mastoid radical surgery of open type with hearing reconstruction,it is right to take comprehensive consideration for fistula lesions,and it is useful to take Ⅱ stage surgery for larger and more serious fistula.
出处
《中国医药导报》
CAS
2013年第8期61-62,共2页
China Medical Herald
关键词
慢性中耳炎
迷路瘘管
乳突根治术
听力重建
Chronic otitis media
Labyrinth fistula
Mastoid radical mastectomy
Hearing reconstruction
