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目的探讨改良乳突根治术,观察术后听力和有无胆脂瘤复发及其并发症。方法作耳内切口,剥离骨膜暴露乳突及鼓窦区,自外耳道后上三角区打开鼓窦,开放部分上鼓室,必要时切除砧骨,保留外耳道后壁及鼓室外侧壁,向乳突腔扩展。清除鼓室及鼓窦,乳突气房病灶,剪开外耳道皮管,将皮瓣置入乳突腔。结果本文450例(450耳)乳突根治术病例中,48例(48耳)胆脂瘤进行了改良乳突根治术,术后随访18～25年者41例仍保存125～1000Hz频率段10～25dB内的气导听力,无胆脂瘤和其他并发症发生。结论41例(41耳)改良乳突根治术后随访,25年31耳(75.61%),18年者10耳(24.39%),仍然保存在一定适用听力范围,CT及病理组织学检查并无胆脂瘤复发及其他并发症的发生,此种手术术式仍具有一定的实用价值。
Objective To explore the modified mastoidectomy, to observe the postoperative hearing and whether the recurrence of cholesteatoma and its complications. Methods Open the ear canal and dissect the periosteum to expose the mastoid and the sinochord area. Open the drum sinus from the upper posterior triangular area of the external auditory canal, open part of the upper tympanic cavity, remove the incus if necessary, keep the posterior wall of the external auditory canal and the lateral wall of the tympanic cavity, Expand. Clear the tympanic and the sinuses, mastoid air room lesions, cut the external auditory canal skin, the flap into the mastoid cavity. Results Forty-eight cases (48 ears) of cholesteatoma were performed radical mastectomy in 450 cases (450 ears) of radical mastoidectomy, and 41 cases were followed up for 18 ~ 25 years ~ 25dB air conduction hearing, no cholesteatoma and other complications. Conclusions 41 cases (41 ears) were followed up after radical mastectomy, with 25 cases of 31 ears (75.61%) and 18 ears of 10 ears (24.39%), which were still preserved in certain applicable hearing areas. CT and histopathological examination did not Cholesteatoma recurrence and other complications, this surgical procedure still has some practical value.