【摘要】 目的探讨软骨鼓膜修补联合Ⅲ型鼓室成形治疗粘连性中耳炎的疗效。方法回顾性分析5 1例接受手术治疗的粘连性中耳炎患者,术中切除粘连的鼓膜及瘢痕组织,去除锤骨、砧骨,行Ⅲ型听力重建,穿孔的鼓膜用全厚耳屏软骨修补。结果5 1例患者均于术后4～6周干耳,鼓膜解剖形态基本正常,但稍厚,活动差。术后3个月纯音测听(0.2 5,0.5,1,2,4 kHz)骨气导差(ABG)为2 3.8 dB,提高了1 8.1 dB。术后1年为1 3.4 dB,提高了2 8.5 dB。随访1年以上,稍厚的软骨鼓膜变薄,活动能力好,无1例穿孔,声导抗测试鼓室图全为As型曲线。结论软骨鼓膜修补联合Ⅲ型鼓室成形治疗粘连性中耳炎效果显著,有临床应用价值。更多还原

【Abstract】 Objective To investigate the surgical techniques and the therapeutic effect of adhesive otitis media.Methods 73 patients of adhesive otitis media underwent surgical treatment were retrospectively analyzed.The adhesive tympanic membranes and scars were removed,as well as malleus and incus regardless of their normality.Type Ⅲ tympanoplasty and the myringoplasty with full-thickness tragus cartilages were performed.Results 4-6 weeks after surgery,all the patients obtained dry ear and anatomically normal but a slightly thicker tympanic membranes with poor movement.Membranes improved to normal and obtained good movement after more than 1 year follow-up without perforation in all cases.Acoustic immittance tests showed all tympanogram curve are "As" type.The average values of A-B Gap in pure tone audiometry were 23.8 dB with the increase of 18.1 dB in 3 months after surgery and 13.4 dB with the increase of 28.5 dB in 1 year after surgery.Conclusion Cartilage myringoplasty combined with type Ⅲ tympanoplasty in the treatment of adhesive otitis media obtains good therapeutic effect and has significant clinical application values.更多还原