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目的探讨胆脂瘤型中耳炎术后复发的原因和治疗方法。方法对48例慢性化脓性胆脂瘤型中耳炎术后复发进行治疗。23例经耳内镜下清理复发的胆脂瘤,刮除肉芽;5例行耳甲腔成形术;3例磨低面神经嵴;17例行乳突再根治术。结果48例于处理后5～92d均获得干耳,全部患者随访1年以上,并予耳内镜复查均未见胆脂瘤复发。结论手术不彻底致残留、引流不畅及术后不定期清理术腔是胆脂瘤复发的主要原因。对于术腔已轮廓化、引流好者经耳内镜下清理、换药可痊愈;对于术腔未轮廓化且引流不畅者需行乳突再根治术,外耳道口狭窄者可同期行耳甲腔成形术。
Objective To investigate the causes and treatment of postoperative recurrence of cholesteatoma otitis media. Methods 48 cases of chronic suppurative cholesteatoma otitis media were treated by postoperative recurrence. 23 cases of recurrent cholesteatoma were scored by ear endoscopy to scrape granulation buds, 5 cases underwent ear cavity angioplasty, 3 cases of low facial nerve ridge, 17 cases of radical repair of papillae. Results All the 48 cases received dry ear from 5 to 92 days after treatment. All the patients were followed up for more than 1 year. No recurrence of cholesteatoma was found by endoscopic retrospective study. Conclusions The main reason for the recurrence of cholesteatoma is incomplete operation, poor drainage, and improper postoperative cleaning of the luminal cavity. For the contours of the surgical cavity has been well drained drainage by ear endoscopy, dressing can be cured; for non-contoured and poor drainage of those who need radical mastoid radical surgery, external auditory canal stenosis who can be the same line Endoloplasty.