鼓室硬化的外科手术治疗及疗效分析

张绍兴; 马芙蓉; 潘滔; 柯嘉; 张珂; 宋昱; 姜立伟

doi:10.13201/j.issn.1001-1781.2015.14.002

鼓室硬化的外科手术治疗及疗效分析

- 北京大学第三医院耳鼻咽喉头颈外科(北京, 100191)
基金项目:
2011首都卫生发展科研专项项目(No:2011-4023-03)

详细信息

通讯作者: 马芙蓉,E-mail:furongma@126.com

中图分类号: R764.21

收稿日期: 2015-05-28

Clinical analysis of tympanosclerosis:characteristics and treatment

- Department of Otorhinolaryngology-Head and Neck Surgery, Peking University Third Hospital, Beijing, 100191, China

More Information

Corresponding author: MA Furong, E-mail: furongma@126.com

Received Date: 28 May 2015

摘要

摘要: 目的:探讨鼓室硬化的临床表现特点、诊断和治疗。方法:回顾分析2006-02-2014-05期间资料完整且随访1年以上的73例鼓室硬化患者。结果:①临床分型Wielinga Ⅰ型17例,Ⅱ型23例,Ⅲ型8例,Ⅳ型25例;②鼓膜、锤骨、砧骨、鼓窦、上鼓室、面神经管、镫骨、镫骨肌腱、圆窗、鼓岬、咽鼓管、鼓膜张肌等处皆可见到硬化灶,其中以锤砧骨、镫骨等中耳传音结构区域多见;③73例患者术前言语频率气导平均听阈为(51.70±14.93)dB HL,术后1年随访时为(36.24±11.58)dB HL,术后1年总成功率为83%(61/73)。结论:鼓室硬化以传导性聋为主。根据病变范围、听力状况,遵循鼓室成形术和镫骨手术的原则选用适当的方法,以恢复和重建传音结构、提高听力;镫骨周围的病灶处理是难点。
- tympanosclerosis /
- otitis media /
- conductive hearing loss /
- tympanoplasty /
- reconstruction of hearing chain
Abstract: Objective: To explore the clinical characteristics, diagnosis and surgical management of tympanosclerosis.Method: The data of 73 patients who underwent surgery for tympanosclerosis were retrospectively analyzed with respects to the clinical characteristics, diagnosis and management.Result: Seventy-three patients with tympanosclerosis (involving 73 ears), including 17 patients with sclerosis of tympanic membrane (type Ⅰ), 23 patients with fixed Malleus-incus complex (type Ⅱ), 8 (type Ⅲ) with fixed stapes, and 25 (type Ⅳ) with extensive typannosclerosis. Sclerosis was seen most frequently in the malleus, incus and attic, followed by the tympanic membrane, incudomalleolar joint and other regions. Audiometry was performed for all the patients 1 weeks before and 1 year (the least) after operation, which were (51.70±14.93)dB HL and (36.24±11.58)dB HL respectively, with success rate 83%(61/73).Conclusion: Most of the patients suffer from conductive hearing loss. Teatment of the sclerosis around stapes is a key point. Acording to the sites of lesion and hearing level, hearing structures should be reconstructed by the rules of tympanoplasty and stapes surgery.
- tympanosclerosis /
- otitis media /
- conductive hearing loss /
- tympanoplasty /
- reconstruction of hearing chain

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