【摘要】 目的 研讨完壁式乳突根治+鼓室成形手术对中耳胆脂瘤患者术后听力及机体炎症的影响。方法回顾性分析2018年1月至2022年12月经福建省漳州市医院确诊的中耳胆脂瘤患者102例，依据治疗方法不同分组，分为开放式乳突根治鼓室成形（对照组，51例）和完壁式乳突根治鼓室成形术（观察组，51例），比较两组的手术基础指标、术后听力恢复状况、机体炎症指标以及并发症发生情况。结果 观察组手术操作时间长于对照组，术后干耳及住院的平均时间相比对照组均缩短，差异有统计学意义（P<0.05）。术后半年，观察组气导听阈值、气骨导差阈值相比对照组均降低，差异有统计学意义（P<0.05）。术后3d，观察组3项机体炎症指标（白细胞介素-2、白细胞介素-6以及肿瘤坏死因子-α）检测值相比对照组均降低，差异有统计学意义（P<0.05）。观察组术后出现并发症的患者总占比5.88%(3/51)，少于对照组的19.61%(10/51)(P=0.037)。结论 完壁式乳突根治鼓室成形手术用于中耳胆脂瘤患者的处理，虽然手术操作用时更长，但是能够加快患者术后恢复，改善患者的术后听力状况，减轻机体炎症，并减少并发症的发生。更多还原

【Abstract】 Objective To investigate the effects of complete-wall mastoidectomy combined with tympanoplasty on postoperative hearing and systemic inflammation in patients with cholesteatoma of the middle ear.Methods A retrospective analysis was conducted on 102 patients diagnosed with middle ear cholesteatoma at Zhangzhou Hospital, Fujian Province, from January 2018 to December 2022. Based on different treatment methods,the patients were divided into two groups: the control group(open mastoidectomy with tympanoplasty, n=51) and the observation group(complete-wall mastoidectomy with tympanoplasty, n=51). The basic surgical parameters,postoperative hearing recovery, systemic inflammation markers, and the incidence of complications were compared between the two groups. Results The observation group had a longer surgical duration than the control group.However, the average time for dry ear and hospital stay was significantly shorter in the observation group compared to the control group(P<0.05). Six months after surgery, the air conduction threshold and air-bone gap threshold were significantly lower in the observation group than in the control group(P<0.05). Three days postoperatively,the levels of three systemic inflammation markers(interleukin-2, interleukin-6, and tumor necrosis factor-α) were significantly lower in the observation group compared to the control group(P<0.05). The overall complication rate in the observation group was 5.88%(3/51), significantly lower than that in the control group, which was 19.61%(10/51)(P=0.037). Conclusion Complete-wall mastoidectomy combined with tympanoplasty for the treatment of middle ear cholesteatoma, although requiring a longer surgical time, facilitates faster postoperative recovery, improves postoperative hearing, reduces systemic inflammation, and decreases the incidence of complications.更多还原