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中耳胆固醇肉芽肿不同治疗术式的选择

THE DIAGNOSIS AND THERAPY FOR CHOLESTEROL GRANULOMA OF MIDDLE EAR

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【作者】 李翔宇孙海燕梁振胡艳红张刚李淑静李云霞

【Author】 Li Xiangyu;Sun Haiyan;Liang Zhen;Department of Otolaryngology Head and Neck Surgery,Tangshan Union Medical College Hospital;

【机构】 河北省唐山市协和医院耳鼻咽喉头颈外科唐山职业技术学院耳鼻喉科

【摘要】 目的探讨中耳胆固醇肉芽肿不同术式的选择依据。方法回顾性分析该院2009年8月—2015年8月收治接受中耳乳突手术治疗并经病理检查证实中耳胆固醇肉芽肿52例(52耳)的临床资料。结果本组接受完壁式乳突根治术35耳;接受开放式乳突根治加鼓室成形术17耳。术中发现35例(35耳)胆固醇肉芽肿的发病部位为鼓窦、鼓窦入口及乳突。45例(45耳)术后语言频率听力平均提高>15dB,50例(50耳)气骨导差缩小至20dB以内,52例(52耳)气导听力均达到应用水平者(语言频率平均听阈50dB以内)。结论临床上对中耳胆固醇肉芽肿患者应根据病变部位、病变范围、病变与周围神经血管结构的关系及患者全身状态的不同选择开放式和完壁式手术,手术目的是尽量清除病变、解除阻塞,重建咽鼓管-鼓室-乳突气房通道或将阻塞区向外耳道开放。

【Abstract】 Objective To explore the diagnosis for cholesterol granuloma of middle ear,and discuss the effect of middle ear surgery for this disease.Methods The files of 52 patients with cholesterol granuloma of middle ear were reviewed in a retrospective study from August 2009 to August 2015.All patients received middle ear and mastoid surgery,and all involved tissues were verified as cholesterol granuloma by pathologic examination.Results There were 35 ears with end wall radical mastoidectomy and 17 ears with open mastoidectomy with tympanoplasty.The pathogenic site of cholesterol granuloma in 35 patients was antrum tympanicum,aditus ad antrum and mastoid.The hearing threshold after surgery of all patients improved of over 15 dB,the air-bone gap was over 45 ears.Conclusions The hearing should be retained and the general status of patients with different personal choice and open-end wall of the operation,the purpose of the operation is to clear the lesions,lifting of the blockage,the tube reconstruction- attic- or the mastoid air atrium Block are will be open to the external ear canal

【基金】 河北省科技成果转化中心课题(编号:冀科成转鉴字2015第9-926号)
  • 【文献出处】 中国煤炭工业医学杂志 ,Chinese Journal of Coal Industry Medicine , 编辑部邮箱 ,2016年07期
  • 【分类号】R764.92
  • 【下载频次】60
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