【摘要】 目的探讨乳突根治术后不干耳的常见原因及防治方法。方法对30例行乳突根治术后不干耳患者的临床资料进行分析。结果 30例中3例因术后换药不当、术腔遗留异物造成的不干耳者,经正确换药后达到干耳;余27例中13例术腔内肉芽增生或胆脂瘤残留、复发(窦脑膜角3例,乳突尖2例,上鼓室前隐窝2例,鼓室窦及面神经隐窝6例),6例面神经嵴过高,2例咽鼓管感染,6例外耳道及其外耳道口狭窄,均再次行手术治疗,术后1个月干耳13例,2个月干耳19例,3个月干耳5例,随访半年以上,中耳乳突腔均干燥。结论乳突根治术后不干耳的常见原因有:病灶残留,引流不畅,咽鼓管途径感染、换药不当及遗留异物等诸多因素。正确选择手术方式,规范手术操作,彻底清除病灶,保持术腔引流通畅,避免咽鼓管途径感染,合理术后换药,是避免中耳乳突术后不干耳的关键。更多还原

【Abstract】 Objective To investigate the common causes and prevention methods of failure to achieve dry ear after radical mastoidectomy.Methods Clinical data of 30patients with wet ears after radical mastoidectomy were analyzed.Results Of the 30patients,3failed to achieve dry ear due to inappropriate postoperative dressing and foreign body residue in surgical cavity,but had dry ear after dressing change.Among the other 27patients,13patients had granulation tissue hyperplasia or cholesteatoma residue and recurrence(sinus meninx angle in 3,mastoidale in 2,anterior epitympanic recess in 2,and sinus tympani and facial recess in 6),6patients had excessively high neural crest,2had eustachian tube infection,and 6had external auditory canal stenosis.All the 27patients underwent reoperation,and dry ear was achieved in 13,19and 5patients 1,2and 3 months after reoperation,respectively.After follow-up for more than 6months,patients had dry middle ear and mastoid cavity.Conclusion The common causes of failure to achieve dry ear after radical mastoidectomy include lesion residue,inadequate drainage,eustachian tube infection,inappropriate dressing,and foreign body residue.The correct operation procedure,standardized operation,removal of focus thoroughly,maintenance of cavity drainage,avoidance of eustachian tube infection,and reasonable postoperative dressing are the keys to prevent failure to achieve dry ear after radical mastoidectomy.更多还原