上鼓室进路并外耳道及鼓室成形术的临床分析

邓毅; 邢奋丽; 吴元庆; 初亭; 陈荣荣; 陈尔东; 樊贤超

doi:10.13201/j.issn.1001-1781.2012.16.011

上鼓室进路并外耳道及鼓室成形术的临床分析

- 南京医科大学附属南京医院南京市第一医院耳鼻咽喉科(南京, 210006)
基金项目:
南京市医学科技发展项目(No:YKK09061)

详细信息

通讯作者: 邓毅,E-mail:drdengyi@hotmail.com

中图分类号: R764.9

收稿日期: 2011-09-23

Atticotomy with canaloplasty and tympanoplasty for limited epitympanic cholesteatoma

- 1. Department of Otolaryngology, Nanjing Medical University Affiliated Nanjing First Hospital, Nanjing, 210006, China

More Information

Corresponding author: DENG Yi, E-mail: drdengyi@hotmail.com

Received Date: 23 September 2011

摘要

摘要: 目的:观察上鼓室切开结合外耳道和鼓室成形术治疗主要局限于上鼓室胆脂瘤的临床疗效。方法:采用上鼓室进路治疗31例病灶主要限于上鼓室的胆脂瘤患者,并于清除病灶后,用耳屏或耳甲腔软骨/软骨膜行外耳道成形和鼓室成形术,重建上鼓室外侧壁和恢复传音结构。结果:经上鼓室外侧壁重建和鼓室成形术后,除2耳鼓室硬化者外,余听力都有提高或保持正常状态,仅有1例出现鼓膜穿孔,31例均未发现囊袋状内陷或胆脂瘤再发。结论:上鼓室切开进路,I期用软骨/软骨膜行外耳道成形和鼓室成形术,较好地恢复了外耳道及中耳结构形态和功能,对治疗局限于上鼓室的胆脂瘤和防止复发的效果好。
- 上鼓室 /
- 胆脂瘤 /
- 上鼓室切开术 /
- 鼓室成形术
Abstract: Objective: To observe the surgical results of atticotomy with canalopalsty and tympanoplasty for limited cholesteatoma.Method: Thirty-one cases of limited epitympanic cholesteatoma and retraction pocket received atticotomy. The surgical procedure consisted of eliminating cholesteatoma and pocket, reconstructing lateral epitympanic wall and tympanoplasty with cartilage/perichondrium island flap.Result: The anatomic pattern of external ear canal appeared near normal, and the hearing level improved or remained normal during 2-year follow up except for 2 cases with tympanosclerosis. No epitympanic retraction pocket or cholesteatoma relapsed. 1 case appeared tympanic perforation.Conclusion: Atticotomy, contemporaneous reconstruction of lateral epitympanic wall and tympanoplasty with cartilage/perichondrium, indicated to be a reliable treatment and prevention technique for epitympanic cholesteatoma. It can achieve good morphological and functional results.
- epitympanum /
- cholesteatoma /
- atticotomy /
- tympanoplasty

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参考文献(8)

[1]	PALVA T, RAMSAY H. Aeration of Prussak's space is independent of the supradiaphragmatic epitympanic compartments[J]. Otol Neurotol, 2007, 28: 264-268.
[2]	迟放鲁, 王正敏, 吴琍雯. 上鼓室封闭和外侧壁重建技术在鼓室成形术中的应用[J]. 中华医学杂志, 2002, 82(23):1617-1618.
[3]	刘阳, 孙建军, 林勇生. 保留骨桥的乳突鼓室成形术(IBM)远期疗效与相关技术再探讨[J]. 中华耳科学杂志, 2007, 5(2):148-151.
[4]	GEHRKING E. Osteoplastic atticoantrotomy with autologous bone chips and a bony attic strut in cholesteatoma surgery[J]. Eur Arch Otorhinolaryngol, 2010, 267:1055-1066.
[5]	EAST D M. Atticotomy with reconstruction for limited cholesteatoma[J]. Clin Otolaryngol Allied Sci, 1998, 23:248-252.
[6]	PENNINGS R J, CREMERS C W. Postauricular approach atticotomy:a modified closed technique with reconstruction of the scutum with cymbal cartilage[J]. Ann Otol Rhinol Laryngol, 2009, 118:199-204.
[7]	BARBARA M. Lateral attic reconstruction techni-que:pr-eventive surgery for epitympanic retraction pockets[J]. Otol Neurotol, 2008, 29:522-525.
[8]	童步升, 杨见明, 吴开乐, 等. 上鼓室重建及鼓室成形术在开放式乳突根治中的应用[J]. 安徽医科大学学报, 2009, 44(2):283-284.