【摘要】 目的 :探讨慢性化脓性中耳炎活动期听力重建的可能性。方法 :对 34例慢性中耳炎患者于活动期行鼓室探查 ,取出锤、砧骨 ,开放鼓峡 ,行鼓室成形术。其中 ,2 3例用自体听骨重建听骨链 (自体听骨组 ) ,1 1例用人工钛听骨重建听骨链 (人工钛听骨组 )。结果 :34例术后 3个月平均气导听力提高 1 5～ 30dBHL。术后 1年 ,自体听骨组 2 3例中 ,6例听力下降至术前水平 ,其中 1例穿孔 ;人工钛听骨组 1 1例中 ,1例听力明显下降 ,移植物完整 ,位置正常。 34例听力提高 (1 5dB以上 )率为 79.4 % (2 7/ 34) ,其中人工钛听骨组听力提高率为 90 .9% (1 0 /1 1 ) ,未见排斥 ;自体听骨组为 73.9% (1 7/ 2 3)。人工钛听骨组听力提高明显优于自体听骨组 ,差异有极显著性意义 (P <0 .0 1 )。结论 :慢性化脓性中耳炎活动期行鼓室成形听力重建是可行的 ;彻底开放鼓峡 ,清除上鼓室、鼓窦入口病灶 ,选择良好的听骨赝复物 ,是手术取得成功的关键更多还原

【Abstract】 Objective:To research the presisting reason of chronic otitis media and the possibility of audition reconstruction in the period of infection.Method:Tympanoplasty were operated on 34 chronic otitis media patients in the period of infection. In these cases, 23 patients used their own ossicular to reconstruct ossicular chain,11 patients used man made titanium ossicular to reconstruct ossicular chain.Result:Three months after operation,the average of 34 patients’ air conduct audition increased 22.4 + 7.3 dB HL. One year after operation, in the group of the own ossicular used, six patients’ audition decreased to the level as pre operation. Among these cases, one patient’s eardrum perforated. In the group of man made titanium ossicular ,one patient’s audition decreased sharply,but the transplants was integrity and the position was right .Total successful ratio was 79.4 %. In the group of man made titanium ossicular, successful ratio was 90.9 %, no transplants ejected, which was better than the group of the own ossicular used. The difference was obvious (P< 0.01 ).Conclusion:The accretion and occlusion in drum isthmus, negative pressure in mastoid are the presisting reason of chronic otitis media. In the period of infection, operating audition reconstruction is feasible. Opening drum isthmus thoroughly and selecting good ossicular replacements are important factors of successful operation.更多还原