论文部分内容阅读
本文研究单侧或双侧多次分期鼓室成形术失败的病例,包括鼓室成形术后听力检查仍然不好,缺少听骨链支持的前庭窗手术,前庭窗有纤维性或硬化性病灶,以及严重中耳炎前庭窗、圆窗、后鼓室、鼓隐窝及咽鼓管口感染者。唯一方法是先施行乳突鼓室凿开术,彻底清除病灶,然后为了重建有效听力,分期施行Lempert的水平半规管的迷路开窗术。乳突鼓室凿开术:第一期手术即作者1960年改良的Lempert乳突鼓室凿开术与外耳道耳甲软骨成形术。经耳内或耳后径路的自身闭塞的无移植物乳突根治术腔,可以达到永久性干耳。和Lempert 1949年所描述相同,所有感染病灶均应除去。本手术将颞骨气房结构的内容物彻底清除,使水平半规管轮廓露出,将外耳道底削低至下鼓室底平面,使圆窗、前庭窗区彻底暴露,从鼓膜张肌管部切去感染的鼓膜张肌腱。这种无移植物自行缩小的乳突腔,自行堵塞咽鼓管口。因此手术后术腔变成充满蹼样纤维组
This article studies unilateral or bilateral multiple staged tympanoplasty failure cases, including tympanoplasty after the hearing test is still not good, the lack of ossicular chain support of the vestibular surgery, the vestibular window with fibrous or sclerosing lesions, and severe Otitis media vestibular window, round window, rear tympanic cavity, drum crypt and eustachian tube orifice infection. The only way is to first mastoidectomy surgery, complete removal of the lesion, and then in order to rebuild effective hearing, stage implementation of Lempert horizontal semicircular canal labyrinth. Mastoid tympanoplasty: the first phase of surgery that is the author of the modified 1960 Lempert mastoidectomy and external ear canal auricular cartilage plasty. The ear or ear behind the path of its own non-graft graft mastoidectomy, can achieve permanent dry ear. As described by Lempert in 1949, all infected lesions should be removed. The surgical removal of the contents of the temporal structure of the air chamber completely removed so that the outline of the level of semicircular canal exposure, the bottom of the ear canal cut down to the lower tympanic floor plane, the round window, vestibular area completely exposed from the tympanic membrane cut off the infected Tympanic membrane tendon. This non-graft contracted mastoid cavity, blocking the eustachian tube orifice. Therefore, the operation cavity becomes full of web-like fiber group