【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。更多还原

【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.更多还原