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本文复习了148例慢性胆脂瘤型乳突炎患者手术治疗情况,其中9例为双侧,共157耳手术方法系根据胆脂瘤范围和乳突解剖类型决定73%患者因病变广泛,乳突小而硬,术中削掉外耳道后壁,使乳突腔与外耳道相通,便于术后观察与清洁,裸露的乳突腔骨面用移植物覆盖。余27%例病变局限,乳突大而气化好者保留后壁。鼓室成形后,后者听力较好。为保留鼓室腔隙及咽鼓管通畅,防止局部粘连,54%患耳从鼓岬上剥除病变粘膜后,在裸露骨面与修补鼓膜之间,甚至咽鼓管内,铺入硅橡胶膜。如剥除之粘膜少,可放入薄而韧之硅橡胶膜;如去除粘膜较多,则放入较厚而硬之硅橡胶片。此法也适用于二期鼓室成形者,先放入硅橡胶膜并修补鼓膜,6个月后修复听骨链。硅橡胶对组织无反应,能长期留置而无妨,甚至当修补鼓膜穿孔后,仍能
This review of 148 patients with chronic cholesteatoma mastoiditis surgical treatment, of which 9 cases were bilateral, a total of 157 ears Department of cholesteatoma according to the scope and type of anatomy of 73% of patients decided due to extensive disease, milk Suddenly small and hard surgery to cut off the posterior wall of the external auditory meatus, the mastoid cavity and external auditory canal, easy to postoperative observation and cleaning, bare mastoid bone covered with graft. More than 27% cases of disease limitations, mastoid large and gasification good retention of the posterior wall. The tympanic shape, the latter hearing better. In order to preserve the tympanic cavity and eustachian tube patency, prevent local adhesions, 54% of the ear from the promontory on the removal of diseased mucosa, between the bare bone and repair tympanic membrane, or eustachian tube, silicone rubber membrane. Such as stripping the mucous membrane less, can be placed in a thin and tough silicone rubber membrane; such as mucous membrane to remove more, then into the thick and hard silicone rubber sheet. This method also applies to the second stage tympanoplasty, silicone rubber membrane first and repair tympanic membrane, repair ossicular chain after 6 months. Silicone rubber no response to the organization, long-term indwelling without any harm, even when repaired tympanic membrane perforation, can still