美国珊瑚多孔羟基磷灰石人工听骨在治疗慢性胆脂瘤型中耳炎中临.docVIP

美国珊瑚多孔羟基磷灰石人工听骨在治疗慢性胆脂瘤型中耳炎中临 　摘要】 目的 探讨美国珊瑚多孔羟基磷灰石人工听骨在听骨链重建中的作用。方法 选取17例（20耳）慢性胆脂瘤型中耳炎病人，实施乳突开放式鼓室成形术，在显微镜下清除中耳病灶，由于听小骨被胆脂瘤破坏，甚至吸收消失，我们采用剪取适当大小的珊瑚多孔羟基磷灰石骨板，在80℃生理盐水中浸泡5min重新塑形，制成羟基磷灰石人工听骨，然后植入鼓室，在乳突开放式鼓室成形术中行听骨链重建术，达到提高患者听力的目的。并与采用同种自体听骨鼓室成形术的19例(20耳)慢性胆脂瘤型中耳炎病人比较。观察两种不同材料的听骨在手术前后的听力变化。结果 试验组术后气骨导差:（9.4±7.2）dB；对照组术后气骨导差:（8.9±7.4）dB；比较两组病人手术后的气骨导差差异无显著性(Pgt;0.05)。结论 美国珊瑚多孔羟基磷灰石人工听骨生物兼容性好，生物稳定性强，操作简单易行且无并发症，满足中耳重建材料的要求。 【关键词】 珊瑚多孔羟基磷灰石；胆脂瘤型中耳炎；听骨链重建；鼓室成形术 Clinical application of American coral porous hydroxyapatite artifical ear-bones in the treatment of chronic otitis media of cholesteatoma 【Abstract】 Objective To discuss the role of American coral porous hydroxyapatite artifical ear-bones in the ossicular chain econstruction.Methods Seventeen patients (20 ears) with chronic otitis media of cholesteatoma type underwent the open technique tympanoplasty.During the procedure，we clear away the lesions of middle ear and use the proper size of coral porous which was soaked in 0.85% chlocidi Natrii at 80℃ and shaped again after 5 minutes to make the hydroxyapatite artifical ear-bones，and then implant the middle ear cavity to complete the ossicular chain reconstruction which should improve the patients hearing.This procedure was compared with the nineteen patients (20 ears) with chronic otitis media of cholesteatoma type of tympanoplasty with autograft ear-bone.The postoperative and preoperative hearing results were observed between the two groups.Results The postoperative reduction of air-bone gap in test group was 9.4±7.2dB and the postoperative reduction of air-bone gap in control group was 8.9±7.4dB.There was no significant difference between the two groups (Pgt;0.05).Conclusion American coral porous hydroxyapatite artifical ear-bones have fine biological compatibility and biological stability and are easy to perform with no complications，and therefore，adapt to the requirement of middle-ear reconstruction material. 【Key words】 coral porous hydroxyapatite；chro