摘要
目的 探讨粘连型胆脂瘤中耳炎的临床特点。方法 以 5 2耳粘连型胆脂瘤中耳炎为对象 ,其中男 30耳 ,女 2 2耳 ;左侧 2 4耳 ,右侧 2 8耳。年龄 8～ 70岁 ,平均 34 72± 14 0 6岁。全部病例均行鼓室成形术治疗 ,其中开放式 37耳 (71 2 % ) ,完壁式 10耳 (19 2 % ) ,其他 5耳 (9 6 % )。 9耳因合并感音性聋未做听骨链重建 ,行O型鼓室成形术。其余Ⅰ型 1耳 ,改良Ⅲ型 16耳 ,改良Ⅳ型 2 6耳。结果 粘连型胆脂瘤中耳炎占胆脂瘤中耳炎的 34 6 7%。镫骨上部结构消失 2 5耳 (48 1% ) ,明显高于上鼓室型胆脂瘤 (P <0 0 5 )。总听力改善率为 6 9 8% ,其中开放式 75 9% ,完壁式 5 5 6 % ,其他6 0 0 %。术后穿孔 3耳 ,鼓膜紧张部重新粘连 4耳。结论 粘连型胆脂瘤型中耳炎并不少见 ;咽鼓管功能障碍可能是发病的直接原因 ;开放式乳突充填鼓室成形术疗效优于完壁式 ,粘连型胆脂瘤中耳炎选择完壁式应慎重。
Objective To study the clinical characteristics of adhesive type cholesteatoma Methods Fifty two cases (52 ears) of adhesive type cholesteatomas were reviewed Of the 52 cases there were 30 males and 22 females; 24 left ears and 28 right ears The age of the patients ranged from 8 to 70 years All of the patients were treated by tympanoplasty, and the open and close methods were performed in 37 ears and 10 ears, respectively Other methods were employed in the remaining 5 cases Nine ears underwent tympanoplasty type '0' without ossicular re construction for an increase in the threshold of the bone conduction Types Ⅰ, Ⅲ and Ⅳ tympanoplasties were performed in 1, 16 and 26 ears, respectively Results The structures of the upper parts of the stapes had disappeared in 25 ears, which was significantly higher in this series than that in the attic type cholesteatoma The over all recovery rate of hearing was 69 8%, while 75 9% and 55 6% in the open and closed tympanoplasties, respectively Postoperative complications of perforations and re adhesions of the tense part of the tympanic membrane were observed in 3 and 4 ears, respectively Conclusions Adhesive type cholesteatoma is not uncommon The cause of this disease may be the functional defects in the pharynotympanic tube A thorough and effective treatment for the secretory otitis media is crucial for the prevention of adhesive type cholesteatomas The open method tympanoplasty was considered as the first choice for adhesive type cholesteatoma while the closed method must be great careful
出处
《中华耳鼻咽喉科杂志》
CSCD
北大核心
2001年第6期412-414,共3页
Chinese Journal of Otorhinolaryngology
