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目的:探讨完壁式乳突根治鼓室成形术治疗胆脂瘤中耳炎的临床效果和相关的经验教训。方法:对57例胆脂瘤中耳炎患者实施完壁式乳突根治鼓室成形术。结果:随访1~8年,平均3.7年。术后5例感染流脓,其中3例经及时处理得到控制并愈合,2例二次手术处理后愈合;3例术后因胆脂瘤复发行开放式乳突手术获干耳;鼓膜完整但有内陷者29例,其中2级内陷者13例;术后8个月及1年人工听骨脱出各1例。术后言语频率气导听阈降低>10 dB HL为72.2%(39/54),气骨导差<20 dB HL为53.7%(29/54),气骨导差缩小25 dB HL以上占42.6%(23/54)。结论:施行完壁式乳突根治鼓室成形术,如果适应证掌握得当,技术条件许可,患者能按时随访,可以有效保留原中耳乳突解剖结构和改善听力,提高患者生活质量,应予优先选择该术式。
Objective: To investigate the clinical effect and related experiences and lessons of endoscopic mastoidectomy for the treatment of cholesteatoma otitis media. Methods: Fifty-seven patients with cholesteatoma otitis media were treated with complete wall mastoid radical tympanoplasty. Results: The follow-up of 1 to 8 years, an average of 3.7 years. After operation, 5 cases were infected with empyema, of which 3 cases were controlled and healed by timely treatment, 2 cases healed after second operation, 3 cases had dry ear treated by open mastoid surgery after cholesteatoma recurrence, There were 29 cases with invagination, of which 13 cases were with grade 2 invagination; one case received artificial phalanges at 8 months and one year after operation. Postoperative speech frequency reduced the guidewire threshold of air conduction> 10 dB HL to 72.2% (39/54), tracheal conduction difference was <20 dB HL was 53.7% (29/54), and tracheal conduction was reduced by 25 dB HL was above 42.6% (23/54). CONCLUSIONS: Endoscopic mastoidectomy with tympanoplasty is an effective method to treat tympanoplasty. If the indications are properly controlled and the technical conditions permit, patients can follow up on time, which can effectively preserve the anatomy of the original middle ear and improve hearing and improve the quality of life of patients. Select the surgery.