乳突根治术后的外耳道后壁及传音机构重建术

Reconstruction for posterior wall of external meatus and sound transmission aPparatus after radical mastoidectomy

关键词:  乳突根治术  中耳重建术  同种肋软骨

Key words:  radical mastoidectomy  reconstruction of middle ear  homologous costal cartilage

摘要:

为使乳突根治术后耳向外耳道开放的乳突腔重新中耳化和一期行听力重建。方法：用同种异体肋软骨为外耳道后壁重建材料、乳突充填材料、听骨链重建材料，对71例乳突根治术后耳(流脓53耳，干耳18耳)作了中耳重建术。结果：71耳术后经6个月～5年随访，66耳重建中耳腔接近正常生理结构，听力提高15dB以上或达应用水平55耳，占77.5%(55／71)；听力提高未达15dB11耳，占15.5%(11／71)；因不同原因失败5耳占7.0%(5／71)。结论：用同种异体肋软骨行乳突根治术后的中耳重建术，是解决乳突腔重新中耳化，听力重建，防止术腔感染的较理想术式

Abstract:

To reconstruct middle ear structure for open mastoid antrum with external auditory canal after radical mastoidectomy in one-stage.Methods:71 ears of post-mastoidectomy (discharging 53 ears and dried up 18 ears)were undergone with reconstruction of middle ear.The posterior wall of external auditory canal,mastoid cavity and chain of ossicles were reconstructed by homologous costal cartilage.Results:66 ears of 71 cases are near normal structure followed up 6 months to 5 years after operations.The result showed hearing over 15dB are 55 ears(77.5%)and under 15dB are 11 cases(15.5%).Five cases(7.0%) were failed. Conclusion:Reconstruction of middle ear with homologous costal cartilage is a ideal surgery to reconstruct hearing structure and avoid infection of middle cavity after radical mastoidectomy.