中耳胆脂瘤患者应用软组织耳道后壁重建与鼓室成形术治疗效果分析.docVIP

中耳胆脂瘤患者应用软组织耳道后壁重建与鼓室成形术治疗的效果分析 　　[摘要] 目的 分析中耳胆脂瘤病患采用软组织耳道后壁重建与鼓室成形术的临床应用价值。方法 方便选取2010年2月―2016年8月该院收治的97例胆脂瘤中耳炎病患，依据治疗方案的差异性分组即A组（实施开放式乳突根治术医治）40例，B组（采用经典完壁式乳突切除术治疗）30例，C组（使用开放式乳突根治术）27例；对比3组患者疗效的差异性结果。结果 A组的胆脂瘤复发（3例）显著优于B组（7例），差异有统计学意义（P0.05）；且A组听力改善率，平均干耳率显著优于C组11.1%，76.9%（P0.05）。 结论 中耳胆脂瘤患者经软组织耳道后壁重建与鼓室成形术医治后，可将病灶清除，降低并发症发生率，复原外耳道功能，值得在临床推广。 　　[关键词] 乳突切除术；耳后壁重建；胆脂瘤中耳炎 　　[中图分类号] R764 [文献标识码] A [文章编号] 1674-0742（2017）02（b）-0001-03 　　[Abstract] Objective To analyze the clinical application value of soft tissue posterior canal wall reconstruction and tympanoplasty for patients with cholesteatoma of middle ear. Methods Convenient selection 97 cases of patients with cholesteatoma of middle ear from February 2010 to August 2016 were selected and divided into three groups according to the different treatment plans， the group A with 40 cases adopted the Open radical mastoidectomy， while the group B adopted the classic improved wall mastoidectomy， and the group C with 27 cases adopted the open mastoidectomy， and the different in the curative effect between the three groups was compared. Results The recurrence of cholesteatoma in the group A was obviously better than that in the group B（3 cases vs 7 cases）， and the difference had statistical significance（P0.05）， and the hearing improvement rate and average dry ear rate in the group A were obviously better than those in the group C（P0.05）. Conclusion The soft tissue posterior canal wall reconstruction and tympanoplasty for patients with cholesteatoma of middle ear can clear the lesions， reduce the incidence rate of complications and restore the acoustic duct function， which is worth clinical promotion. 　　[Key words] Mastoidectomy； Posterior canal wall reconstruction； Otitis media with cholesteatoma 　　在临床中，多数胆脂瘤型中耳炎病症常因骨性外耳道后壁不完整，或者病变侵犯范围扩大而采用完壁式乳突切除术医治，但无法将病灶处全部予以清除[1]。现发现利用颞肌骨膜瓣转移外耳道后壁重建技术以及鼓室重建技术[2]治疗中耳胆脂瘤病症已然取得临床认可。为分析中耳胆脂瘤患者使用软组织耳道后壁重建与鼓室成形术治疗的有效性，现将该院2010年2月―2016年8月收治的97例患者作分组试验，给予不同术式疗法，现报道如下。 　　1 资料与方法 　　1.1