【摘要】 目的探讨慢性化脓性中耳炎手术中应用自体骨粉及耳后肌骨膜瓣缩小根治腔对开放式鼓室成形术疗效的影响。方法总结分析2002年3月-2012年7月间56例患者,术中应用自体肌骨膜瓣及自体骨皮质骨粉及纤维蛋白凝血酶粘合剂充填上鼓室、乳突尖和术腔凹凸不平骨坑,骨粉表面覆盖筋膜,粘合剂固定,分别于术后3个月、6个月观察乳突腔缩小、干耳时间及术腔上皮化情况。结果全部患者切口均I期愈合,乳突腔明显缩小,听力明显提高,干耳时间4～9周,平均为6周,干耳率94.64%(53/56)。结论病灶清除不彻底,术腔难于清理是乳突根治手术失败的主要原因。乳突腔彻底开放,轮廓化,应用自体骨粉及耳后肌骨膜瓣缩小根治腔并同期行耳甲腔成形术及鼓室成形术,能够使术腔上皮化迅速,干耳快,并发症少,是开放式鼓室成形术切实可行的方法。更多还原

【Abstract】 Objective To study the effects of the autogenous bone pate and postauricular musculo-periosteal flap on canal wall up tympanomastoidectomy in surgery for chronic suppurative otitis medium(CSOM).Methods The clinic data of 56 patients undergoing the surgery for chronic suppurative otitis medium from March 2002 to July 2012 were analyzed.The autogenous bone pate,postauricular musculo-periosteal flap and fibrin adhesive were used to fill the attic,mastoidale and rugged surface of the bone.The face of bone pate was covered with fascia,and fixed with adhesive.The shrink of mastoid avity,time of dry ear and epithelization were observed 3 and 6 months after the surgeries.Results The incision of all patients was healing by first intention,the mastoid cavity were significantly reduced,the hearing had a distinct improvement,the time of dry ear was 4-9 week,and average time was 6 weeks,the rate of dry ear was 94.64%(53/56).Conclusion The use of the autogenous bone and postauricular musculo-periosteal flap in the plastic surgery of external auditory canal can improve the speed of epithelization,shorten the time of dry ear and reduce complications,is a practical method of open tympanoplasty.更多还原