镫骨手术并发镫井喷3例报告.pdfVIP

维普资讯 l78 ChinOtorhinolaryngolJIntegMed2008，Vo1．16No．3 镫骨手术并发镫井喷3例报告 方文旭 蔡志福 【摘要】目的 报告镫骨手术中并发镫井喷3例及其处理方法。方法 回顾性分析镫骨手术中发生镫井喷3例患者的处理 经过。首先吸除术野中脑脊液至不再有液体流出，然后取填塞物进行填塞，可用填塞物包括动物胶、骨腊、筋膜、肌肉、静脉 瓣等。结果 经及时处理，3例患者均止住了脑脊液溢出。术后随访2年，2例未再发生继发性脑膜炎，其中l例眩晕和耳呜均消 失。结论 对准备行镫骨手术或内耳开放的患者，术前必须作高分辨CT，确定有无内耳畸形，并仔细询问家族史。 【关键词】镫骨手术；并发症；镫井喷；修补；疗效 Stapedialgushercomplicatedduringstapessurgery(withthreecasesreport) FANG Wenxu，CAl zhifu Dept．of Otolaryngo]ogy,theAffiliatedHospitalofPutJan CoJJege,}ujian351100,China [Abstract]ObjectiveToreport3casesundergonestapessurgerycomplicatedwithstapedialgusherduringtheoperation andtodiscusstheprocedurestotreatthiscondition．M ethod A rertospectivestudywascarriedoutamong3casesundergonestapes surgery andcomplicatedwithstapedialgusherduringtheoperationtosum uptheclinicalexperiencewithitsrteatingprocess．Totreat suchacondition，cerebrospinalfluidleakingintotheoperatingfieldwasdrainedawaybysuckingtillnofluidpresentinthefieldany moreatfirst，andthen，pluggingwasdonewithmanykindsofavailablematerials，suchasbioglue，bonewax，fascia，muscle，venous flapandSOon．Results Followingtheappropriatetreatment，cerebrospinalfluidleakingwassuccessfullystoppedduringhteoperating periodamongallhte3cases．Bytheendoffollowingupperiodlastedfortwoyearsafterthesurgery,hte2caseswiht repeatedlyoccurring otogenousmeningitisbeforetheoperationwereseenwihtoutsuchaconditionrecurrednaymore，andhteotheronecaseWas observedwiht hisvertigonadtinnitusdisappeared．ConclusionsItisnecessaryofrhtepatientsundergoingstapessurgery orinnerearopeningsurgery to preoperativelytakeaHRCT scanningtomakesurehtepossibilitywiht orwihtoutinnerearmalformations，nadsupplementde bycraefully niquiringabouthteassociatedfamilyhistory． [Keywords]Stapessurgery；Complica