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摘要: 目的:探讨在全耳内镜下经外耳道治疗上鼓室内陷袋的临床效果及手术要点和技巧。方法:回顾性分析用全耳内镜完成上鼓室内陷袋手术治疗的25例(25耳)患者的资料。分别于术后1、3、6个月复查耳内镜,术后6个月加做纯音听阈测试、声导抗检查及颞骨高分辨CT检查。结果:25例(25耳)患者术后1个月复查穿孔愈合率为100％,均无感染、耳鸣、眩晕、听力下降等并发症。术后6个月复查,所有患者的鼓膜形态良好,未见再穿孔,鼓膜紧张部及松弛部无内陷、粘连;术前平均气导听阈为(39.59±8.37) dB HL,术后6个月为(26.21±7.51) dB HL,术前术后比较差异有统计学意义(t=8.265,P<0.01);术前平均气骨导差为(28.67±6.58) dB HL,术后6个月为(13.63±7.33) dB HL,术前术后比较差异有统计学意义(t=11.862,P<0.01)。术后6个月声导抗复查均为A型。结论:全耳内镜下经外耳道治疗上鼓室内陷袋,具有图像清晰、视野广、操作简单、创伤小、手术时间短、效果确切、病变残留及复发率减少的优点,值得推广。Abstract: Objective: To explore the clinical effect, key points and techniques of otoendoscopic surgery in patients with attic retraction pocket. Method: Data of 25 patients (25 ears) of chronic suppurative otitis media who treated with transcanal endoscopic ear surgery for attic retraction pocket were retrospectively analyzed. Patients were examined by otoendoscopes at postoperative 1, 3 and 6 month,respectively. Patients were tested by pure tone audiometry,tympanometry test and high resolution CT of temporal bone at postoperative 6 month. Result: The healing rate of perforation was 100% in 25 patients (25 ears) at postoperative 1 month. There was no infection, tinnitus, vertigo, decrease of air-bone conduction hearing and other complications. All patients had good tympanic membrane shape, no perforation, no invagination or adhesion in tympanic membrane at postoperative 6 month.The mean preoperative air conduction threshold was (39.59±8.37)dB HL, while it was (26.21±7.51)dB HL at postoperative 6 month (t=8.265,P<0.01).The mean preoperative air-bone gap was (28.67±6.58)dB HL, while it was (13.63±7.33)dB HL at postoperative 6 month (t=11.862,P<0.01).The mean air conduction threshold and the mean preoperative air-bone gap were significantly improved compared with those preoperative (P<0.01). Tympanometry test was "A" type at postoperative 6 month. Conclusion: The treatment of attic retraction pocket by otoendoscopes through external auditory canal has the advantages of clear image, wide field of vision, simple operation, less trauma, short operation time, accurate effect, and can reduce the residual and recurrence of lesions.
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Key words:
- tympanic membrane /
- attic /
- retraction pocket /
- otoendoscopes
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