参与讨论专家(按姓氏汉语拼音排序)：
崔勇(广东省人民医院耳鼻咽喉科)；陈正侬(上海交通大学医学院附属第六人民医院耳鼻咽喉头颈外科)；邓安春(陆军军医大学第二附属医院耳鼻咽喉头颈外科)；丁秀勇(首都医科大学宣武医院耳鼻咽喉头颈外科)；冯宁宇(银川市第一人民医院耳鼻咽喉科)；高伟(空军军医大学唐都医院耳鼻咽喉头颈外科)；侯昭晖(中国人民解放军总医院耳鼻咽喉头颈外科医学部)；韩朝(复旦大学附属东华医院耳鼻咽喉科)；惠莲(中国医科大学附属第一医院耳鼻咽喉科)；刘军(河南省人民医院耳鼻咽喉科)；刘玉和(首都医科大学附属北京友谊医院耳鼻咽喉科)；李阳(西安交通大学第二附属医院耳鼻咽喉头颈外科)；廖华(武汉大学人民医院耳鼻咽喉头颈外科)；赖彦冰(华中科技大学同济医学院附属同济医院耳鼻咽喉头颈外科)；马小洁(山东大学齐鲁医院耳鼻咽喉科)；梅凌云(中南大学湘雅医院耳鼻咽喉头颈外科)；瞿申红(广西壮族自治区人民医院耳鼻咽喉头颈外科)；孙岩(青岛大学附属烟台毓璜顶医院耳鼻咽喉头颈外科)；孙宇(华中科技大学同济医学院附属协和医院耳鼻咽喉科)；孙家强(中国科学技术大学附属第一医院耳鼻咽喉头颈外科)；王方园(中国人民解放军总医院耳鼻咽喉头颈外科医学部)；王武庆(复旦大学附属眼耳鼻喉科医院耳鼻咽喉科)；王巍(天津市第一中心医院耳鼻咽喉头颈外科)；王博琛(佛山市第一人民医院耳医学中心)；汪芹(中南大学湘雅二医院耳鼻咽喉头颈外科)；汪照炎(上海交通大学医学院附属第九人民医院耳鼻咽喉头颈科)；虞幼军(佛山市第一人民医院耳医学中心)；袁伟(重庆市人民医院耳鼻咽喉科)；伊海金(清华大学附属北京清华长庚医院耳鼻咽喉头颈外科)；杨海弟(中山大学孙逸仙纪念医院耳鼻咽喉科)；杨荣刚(贵州中医药大学第二附属医院耳鼻咽喉科)；杨琼(华中科技大学协和深圳医院耳鼻咽喉科)；曾宪海(深圳市耳鼻咽喉研究所深圳市龙岗区耳鼻咽喉医院耳鼻喉科)；赵宇(四川大学华西医院耳鼻咽喉头颈外科)；张杰(首都医科大学附属北京儿童医院耳鼻咽喉头颈外科)；钟时勋(重庆医科大学附属第一医院耳鼻咽喉头颈外科)；张文(陕西省人民医院耳鼻咽喉头颈外科)；张天虹(哈尔滨医科大学附属第一医院耳鼻咽喉头颈外科)；张小安(广东省人民医院赣州医院耳鼻咽喉头颈外科)
执笔人：
赖彦冰 华中科技大学同济医学院附属同济医院耳鼻咽喉头颈外科
王博琛 佛山市第一人民医院耳医学中心
虞幼军 佛山市第一人民医院耳医学中心
侯昭晖 中国人民解放军总医院耳鼻咽喉头颈外科医学部
廖华 武汉大学人民医院耳鼻咽喉头颈外科中心
Specialist consensus on endoscopic surgery of the middle ear mastoid
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摘要: 本文从多角度探讨耳内镜下中耳乳突部手术，首先从病变性质和影像学表现来讨论手术的适应证和禁忌证; 其次推荐适用设备，详细介绍手术方式; 最后从功能和重建的角度总结了中耳乳突部术腔的处理原则。本文旨在通过阐述耳内镜中耳乳突部手术，以期为开展相关手术提供参考或指导意义。Abstract: This article discusses otoscopic middle ear mastoid surgery from multiple perspectives. Firstly, it discusses the indications and contraindications for surgery from the nature of the lesion and the imaging manifestations; secondly, it recommends the applicable equipment and describes the surgical approach in detail; finally, it summarizes the principles of the management of the operative cavity of the mastoid process in the middle ear from the perspectives of function and reconstruction. The purpose of this article is to illustrate otoscopic middle ear mastoid surgery with the aim of providing reference or guidance for performing related surgeries.
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Key words:
- endoscopic /
- mastoid /
- surgery /
- management of cavity
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[1] Anschuetz L, Siggemann T, Dür C, et al. Teaching Middle Ear Anatomy and Basic Ear Surgery Skills: A Qualitative Study Comparing Endoscopic and Microscopic Techniques[J]. Otolaryngol Head Neck Surg, 2021, 165(1): 174-181. doi: 10.1177/0194599820977191
[2] Han SY, Lee DY, Chung J, et al. Comparison of endoscopic and microscopic ear surgery in pediatric patients: A meta-analysis[J]. Laryngoscope, 2019, 129(6): 1444-1452. doi: 10.1002/lary.27556
[3] Manna S, Kaul VF, Gray ML, et al. Endoscopic Versus Microscopic Middle Ear Surgery: A Meta-analysis of Outcomes Following Tympanoplasty and Stapes Surgery[J]. Otol Neurotol, 2019, 40(8): 983-993. doi: 10.1097/MAO.0000000000002353
[4] Tarabichi, M. Endoscopic middle ear surgery[J]. The Annals of Otology, Rhinology, and Laryngology, 1999, 108(1): 39-46. doi: 10.1177/000348949910800106
[5] Yong M, Mijovic T, Lea J. Endoscopic ear surgery in Canada: a cross-sectional study[J]. J Otolaryngol Head Neck Surg, 2016, 45: 4. doi: 10.1186/s40463-016-0117-7
[6] 廖华, 杨希林, 汪雷, 等. 持续灌流模式耳内镜下Ⅰ型鼓室成形术[J]. 听力学及言语疾病杂志, 2019, 27(6): 615-618.
[7] 廖华, 虞幼军, 侯昭晖. 持续灌流模式下的耳内镜外科手术[J]. 中华耳科学杂志, 2021, 19(2): 192-197. doi: 10.3969/j.issn.1672-2922.2021.02.002
[8] 孔维佳. 耳鼻咽喉头颈外科学[M]. 2版. 北京: 人民卫生出版社, 2010: 8-9.
[9] Friedmann I. The pathology of otitis media[J]. J Clin Pathol, 1956, 9(3): 229-236. doi: 10.1136/jcp.9.3.229
[10] Marchioni D, Alicandri-Ciufelli M, Gioacchini FM, et al. Transcanal endoscopic treatment of benign middle ear neoplasms[J]. Eur Arch Otorhinolaryngol, 2013, 270(12): 2997-3004. doi: 10.1007/s00405-013-2371-x
[11] Pallanch JF, Weiland LH, McDonald TJ, et al. Adenocarcinoma and adenoma of the middle ear[J]. Laryngoscope, 1982, 92(1): 47-54. doi: 10.1288/00005537-198201000-00010
[12] Baráth K, Huber AM, Stämpfli P, et al. Neuroradiology of cholesteatomas[J]. AJNR Am J Neuroradiol, 2011, 32(2): 221-229. doi: 10.3174/ajnr.A2052
[13] Hanafee WN, Mancuso A, Winter J, et al. Edge enhancement computed tomography scanning in inflammatory lesions of the middle ear[J]. Radiology, 1980, 136(3): 771-775. doi: 10.1148/radiology.136.3.7403559
[14] Maroldi R, Farina D, Palvarini L, et al. Computed tomography and magnetic resonance imaging of pathologic conditions of the middle ear[J]. Eur J Radiol, 2001, 40(2): 78-93. doi: 10.1016/S0720-048X(01)00376-X
[15] Martin N, Sterkers O, Nahum H. Chronic inflammatory disease of the middle ear cavities: Gd-DTPA-enhanced MR imaging[J]. Radiology, 1990, 176(2): 399-405. doi: 10.1148/radiology.176.2.2367654
[16] Wang P, Zhang H, Zhao J, et al. External auditory canal and middle ear tumors: characterization by morphology and diffusion features on CT and MRI[J]. Eur Arch Otorhinolaryngol, 2023, 280(2): 605-611. doi: 10.1007/s00405-022-07509-1
[17] Granato L, Silva CJ, Yoo HJ. Isolated congenital cholesteatoma of the mastoid process: a case report[J]. Braz J Otorhinolaryngol, 2012, 78(4): 133. doi: 10.1590/S1808-86942012000400024
[18] MacDonald B, Bommakanti K, Mallo M, et al. Isolated Incudostapedial Cholesteatomas: Unique Radiologic and Surgical Features[J]. Ear Nose Throat J, 2021, 100(3_suppl): 243S-248S. doi: 10.1177/0145561320973785
[19] Nagato T, Otaka R, Wada T, et al. Congenital cholesteatoma isolated to the mastoid presenting as stricture of the external auditory canal[J]. Int J Pediatr Otorhinolaryngol, 2012, 76(5): 754-756. doi: 10.1016/j.ijporl.2012.02.032
[20] Marchioni D, Alicandri-Ciufelli M, Molteni G, et al. Selective epitympanic dysventilation syndrome[J]. Laryngoscope, 2010, 120(5): 1028-1033. doi: 10.1002/lary.20841
[21] Badr-el-Dine M. Value of ear endoscopy in cholesteatoma surgery[J]. Otol Neurotol, 2002, 23(5): 631-635. doi: 10.1097/00129492-200209000-00004
[22] Das A, Mitra S, Ghosh D, et al. Endoscopic Versus Microscopic Management of Attic Cholesteatoma: A Randomized Controlled Trial[J]. Laryngoscope, 2020, 130(10): 2461-2466. doi: 10.1002/lary.28446
[23] Tarabichi M. Endoscopic management of limited attic cholesteatoma[J]. Laryngoscope, 2004, 114(7): 1157-1162. doi: 10.1097/00005537-200407000-00005
[24] 赖彦冰, 虞幼军, 侯昭晖, 等. 对耳内镜手术的思考[J]. 中华耳科学杂志, 2017, 15(4): 426-430.
[25] Lailach S, Kemper M, Lasurashvili N, et al. Health-related quality of life measurement after cholesteatoma surgery: comparison of three different surgical techniques[J]. Eur Arch Otorhinolaryngol, 2015, 272(11): 3177-3185. doi: 10.1007/s00405-014-3370-2
[26] Uzun C, Kutoglu T. Assessment of visualization of structures in the middle ear via Tos modified canal wall-up mastoidectomy versus classic canal wall-up and canal wall-down mastoidectomies[J]. Int J Pediatr Otorhinolaryngol, 2007, 71(6): 851-856. doi: 10.1016/j.ijporl.2007.02.004
[27] Isaacson G. Endoscopic anatomy of the pediatric middle ear[J]. Otolaryngol Head Neck Surg, 2014, 150(1): 6-15. doi: 10.1177/0194599813509589
[28] Marchioni D, Villari D, Alicandri-Ciufelli M, et al. Endoscopic open technique in patients with middle ear cholesteatoma[J]. Eur Arch Otorhinolaryngol, 2011, 268(11): 1557-1563. doi: 10.1007/s00405-011-1533-y
[29] 陈抗松, 邹团明, 王博琛, 等. 全耳内镜下中耳乳突部胆脂瘤手术的短期效果观察[J]. 中华耳科学杂志, 2021, 19(2): 209-212.
[30] 侯昭晖, 李瑞香, 杨仕明. 耳内镜技术在中耳胆脂瘤手术中的应用策略[J]. 中华耳科学杂志, 2017, 15(4): 393-397.
[31] Bottrill ID, Poe DS. Endoscope-assisted ear surgery[J]. Am J Otol, 1995, 16(2): 158-163.
[32] Cömert E, Cömert A. Surgical anatomy of the transcanal infracochlear approach[J]. Eur Arch Otorhinolaryngol, 2022, 279(1): 159-168. doi: 10.1007/s00405-021-06635-6
[33] Gerek M, Satar B, Yazar F, et al. Transcanal anterior approach for cystic lesions of the petrous apex[J]. Otol Neurotol, 2004, 25(6): 973-976. doi: 10.1097/00129492-200411000-00018
[34] Giddings NA, Brackmann DE, Kwartler JA. Transcanal infracochlear approach to the petrous apex[J]. Otolaryngol Head Neck Surg, 1991, 104(1): 29-36. doi: 10.1177/019459989110400107
[35] Güneri EA, Olgun Y. Endoscope-Assisted Cochlear Implantation[J]. Clin Exp Otorhinolaryngol, 2018, 11(2): 89-95. doi: 10.21053/ceo.2017.00927
[36] Hu X, Chen M, Dai W, et al. Efficiency of intraoperative endoscopic inspection in reducing residuals in canal-wall-up surgery for pediatric cholesteatoma involving the mastoid[J]. Eur Arch Otorhinolaryngol, 2023, 280(8): 3593-3600. doi: 10.1007/s00405-023-07857-6
[37] Mattox DE. Endoscopy-assisted surgery of the petrous apex[J]. Otolaryngol Head Neck Surg, 2004, 130(2): 229-241. doi: 10.1016/j.otohns.2003.11.002
[38] Wu N, Zuo W, Wang F, et al. Scutum reconstruction technique and classification in endoscopic middle ear cholesteatoma surgery[J]. Acta Otolaryngol, 2020, 140(11): 904-908. doi: 10.1080/00016489.2020.1791953
[39] 赵丹珩, 贾建平, 王方园, 等. 耳内镜下外耳道"锁孔"技术处理累及乳突的中耳胆脂瘤的初步实践[J]. 中华耳科学杂志, 2021, 19(2): 203-208.
[40] Hou Z, Wang F, Zuo W, et al. Application of a novel transcanal keyhole technique in endoscopic cholesteatoma surgery[J]. Acta Otolaryngol, 2021, 141(4): 328-333. doi: 10.1080/00016489.2021.1871777
[41] Marchioni D, Rubini A, Soloperto D. Endoscopic Ear Surgery: Redefining Middle Ear Anatomy and Physiology[J]. Otolaryngol Clin North Am, 2021, 54(1): 25-43. doi: 10.1016/j.otc.2020.09.003
[42] Moneir W, Hemdan A, El-Kholy NA, et al. Endoscopic transcanal attico-antrostomy versus endoscopic-assisted canal wall up mastoidectomy in management of localized cholesteatoma: a randomized clinical trial[J]. Eur Arch Otorhinolaryngol, 2022, 279(9): 4371-4378. doi: 10.1007/s00405-021-07200-x
[43] Glikson E, Feinmesser G, Sagiv D, et al. Trans-canal endoscopic ear surgery and canal wall-up tympano-mastoidectomy for pediatric middle ear cholesteatoma[J]. Eur Arch Otorhinolaryngol, 2019, 276(11): 3021-3026. doi: 10.1007/s00405-019-05588-1
[44] 吴南, 汪照炎, 虞幼军, 等. 242例耳内镜下中耳胆脂瘤处理及术后效果分析[J]. 中华耳鼻咽喉头颈外科杂志, 2019, 54(4): 251-256.
[45] Cros O, Borga M, Pauwels E, et al. Micro-channels in the mastoid anatomy. Indications of a separate blood supply of the air cell system mucosa by micro-CT scanning[J]. Hear Res, 2013, 301: 60-65. doi: 10.1016/j.heares.2013.03.002
[46] Kania RE, Herman P, Tran Ba Huy P, et al. Role of nitrogen in transmucosal gas exchange rate in the rat middle ear[J]. J Appl Physiol(1985), 2006, 101(5): 1281-1287. doi: 10.1152/japplphysiol.00113.2006
[47] Ars B, Dirckx J. Eustachian Tube Function[J]. Otolaryngol Clin North Am, 2016, 49(5): 1121-1133. doi: 10.1016/j.otc.2016.05.003
[48] Takahashi H, Honjo I, Naito Y, et al. Gas exchange function through the mastoid mucosa in ears after surgery[J]. Laryngoscope, 1997, 107(8): 1117-1121. doi: 10.1097/00005537-199708000-00020
[49] Sadé J, Ar A. Middle ear and auditory tube: middle ear clearance, gas exchange, and pressure regulation[J]. Otolaryngol Head Neck Surg, 1997, 116(4): 499-524. doi: 10.1016/S0194-59989770302-4
[50] Seibert JW, Danner CJ. Eustachian tube function and the middle ear[J]. Otolaryngol Clin North Am, 2006, 39(6): 1221-1235. doi: 10.1016/j.otc.2006.08.011
[51] Tanabe M, Takahashi H, Honjo I, et al. Gas exchange function of the middle ear in patients with otitis media with effusion[J]. Eur Arch Otorhinolaryngol, 1997, 254(9-10): 453-455. doi: 10.1007/BF02439979
[52] Tarabichi M, Ayache S, Nogueira JF, et al. Endoscopic management of chronic otitis media and tympanoplasty[J]. Otolaryngol Clin North Am, 2013, 46(2): 155-163. doi: 10.1016/j.otc.2012.12.002
[53] McDonald MH, Hoffman MR, Gentry LR, et al. New insights into mechanism of Eustachian tube ventilation based on cine computed tomography images[J]. Eur Arch Otorhinolaryngol, 2012, 269(8): 1901-1907. doi: 10.1007/s00405-011-1829-y
[54] Lee WS, Kim SH, Lee WS, et al. Canal wall reconstruction and mastoid obliteration in canal wall down tympanomastoidectomized patients[J]. Acta Otolaryngol, 2009, 129(9): 955-961. doi: 10.1080/00016480802510178
[55] Liu SC, Wang CH, Huang BR. Obliteration of Radical Cavities and Total Reconstruction Procedure Without Staging After Canal Wall Down Mastoidectomy: Long-term Results[J]. Clin Exp Otorhinolaryngol, 2015, 8(3): 230-236. doi: 10.3342/ceo.2015.8.3.230
[56] Dankuc D, Vlaški L, Pejaković N. Techniques of the Tympanomastoidectomy with Reconstruction of the Posterior Bone Wall of the External Auditory Canal[J]. Srp Arh Celok Lek, 2015, 143(7-8): 480-486. doi: 10.2298/SARH1508480D
[57] Hunter JB, Zuniga MG, Sweeney AD, et al. Pediatric Endoscopic Cholesteatoma Surgery[J]. Otolaryngol Head Neck Surg, 2016, 154(6): 1121-1127. doi: 10.1177/0194599816631941
[58] Jenks CM, Purcell PL, Federici G, et al. Transcanal Endoscopic Ear Surgery for Congenital Cholesteatoma: A Multi-institutional Series[J]. Otolaryngol Head Neck Surg, 2022, 167(3): 537-544. doi: 10.1177/01945998211067502
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