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目的总结自体乳突皮质骨粉在中耳乳突手术中的应用价值及经验体会。方法对慢性化脓性中耳炎、胆脂瘤中耳炎患者46例术中应用了自体乳突皮质骨粉修复填充,其中乳突根治术19例,乳突病变切除+鼓室成型术27例。开放乳突前以大号切割钻磨削乳突皮质骨,收集骨粉备用,术中以骨粉填充上鼓室或封闭鼓窦入口,并填充缩小乳突腔,骨粉表面覆盖筋膜。结果所有病例术后术腔明显缩小,平均干耳时间为6周,3个月内干耳率为95.7%(44/46),行鼓室成型术者鼓膜形态正常,无回缩袋形成。结论自体乳突皮质骨粉取材方便、易于塑形、无排斥反应,是中耳乳突手术中理想的修复填充材料。
Objective To summarize the application value and experience of autologous mastoid cortical bone powder in middle ear mastoid surgery. Methods 46 patients with chronic suppurative otitis media and cholesteatoma otitis media were treated with autologous mastoid cortical bone powder repair and filling, of which 19 mastoid radical mastectomy and 27 cases of papillary deformity and tympanoplasty. Before the opening of the mastoid, the large cut was used to grind the mastoid cortex bone to collect the bone powder for backup. The bone powder was filled into the tympanic cavity or closed the entrance of the drumou during operation, and the mastoid cavity was filled and contracted to fill the surface of the fascia. Results The postoperative operative cavity was significantly reduced in all cases. The average dry ear time was 6 weeks. The dry ear rate was 95.7% (44/46) in 3 months. The tympanic membrane was normal and no bag was formed. Conclusion The autologous mastoid cortical bone powder is convenient and easy to be shaped and has no rejection. It is an ideal repair filler for middle ear mastoid process.