目的探讨上鼓室内陷袋和中耳通气功能之间的关系.方法对101人128耳内陷袋患者在耳内镜下检查并行TOS分级,行声导抗检查,记录鼓室图情况.其中25耳内陷袋患者行颞骨高分辨CT检查,并行手术治疗.结果(1)声阻抗结果：128耳内陷袋中,B型鼓室图86耳(67.2%),C型：38耳(29.6%),As型2耳(1.6%),A型2耳(1.6%),有分泌性中耳炎病史共111耳,占86.7%,I级、II级、III级、IV级间的B型和C型鼓室导抗图发生率差异无统计学意义.(2)CT检查结果：内陷袋组气化良好率和气化不良率为4%、96%,其乳突气房平均容积为0.706 cm3±1.708 cm3；和对照组比较差异有统计学意义.(3)手术中证实25例患者上鼓室均有软组织堵塞引流不畅,和CT表现相符率达92%.结论中耳通气不畅和持续负压状态是内陷袋形成的主要原因,内陷袋的形成和咽鼓管功能不良、乳突气化差、分泌性中耳炎多个因素有关,需早期积极恢复咽鼓管功能和治疗分泌性中耳炎,早期改善中耳通气功能防止内陷袋的进展.%Objective To study the relationship between attic retraction pocket and middle ear aeration. Methods Da⁃ta from 101 patients (128 ears) who were suspected of retraction pocket were collected. All the patients received endotosco⁃py examination and tympanometry test. Twenty five ears received HRCT examination and surgical treatment. Results The rate of types B, C, A and As tympanograms was 67.2%, 29.6%, 1.6%and 1.6%, respectively. Secretory otitis media history was identified in 86.7%of the ears (111/128). The degree of attic retraction pocket was not correlated to type B or C tympa⁃nograms. The rate of good and poor mastoid pneumatization was 4%and 96%in ears with retraction pockets, with a mean volume of mastoid air cell of 0.706 ± 1.708 cm3. This was statistically different from the control group. In the 25 surgically treated ears, granulation or cholesteatoma was seen in the attic. Surgery and CT findings were consistent in 92%of the cas⁃es. Conclusion The lack of ventilation and constant negative pressure in the middle ear is the reason for forming attic retrac⁃tion pockets. Attic retraction pockets are related to dysfunction of the Eustachian tube, ill-areation of the mastoid and secre⁃tory otitis media. Ventilation of the middle ear must be improved to prevent worsening of the attic retraction pocket.
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