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目的分析胆脂瘤中耳炎并发迷路瘘管(COM-LF)的诊断及手术疗效。方法 2001年1月至2009年8月在河南省南阳市第一人民医院治疗的COM-LF患者38例,均行瘘管检查与颞骨高分辨率CT扫描,并于局麻或全麻下行乳突根治术。结果本组372例慢性中耳炎患者,并发迷路瘘管38例(10.2%),41耳。39耳完整清除胆脂瘤基质并行Ⅰ期修复瘘管,术后70.7%的患者纯音测听检查骨导平均阈值降低,症状均有所缓解。结论 COM-LF术前诊断较困难,瘘管实验、影像学检查结合术中探查是确诊迷路瘘管的重要依据,应依瘘管部位、大小及患者状态制定手术方案。
Objective To analyze the diagnosis and surgical treatment of cholesteatoma otitis media with fistula (COM-LF). Methods From January 2001 to August 2009, 38 patients with COM-LF treated in Nanyang First People’s Hospital of Henan Province underwent fistula examination and temporal bone high resolution CT scan. The patients underwent mastoid process under local or general anesthesia Radical surgery. Results The group of 372 patients with chronic otitis media, fistula complicated by fistula in 38 cases (10.2%), 41 ears. In 39 ears, cholesteatoma was completely removed and the fistulas were repaired in phase Ⅰ. The average bone conduction index (TGA) was decreased in 70.7% of the patients, and the symptoms were relieved. Conclusion COM-LF preoperative diagnosis is more difficult. Fistula test, imaging examination combined with intraoperative exploration is an important basis for the diagnosis of fistula. It should be based on fistula position, size and patient status to develop surgical options.