目的：探讨耳内镜下双人操作完壁式鼓室成形术治疗慢性中耳炎的临床效果。方法：对收治的45例胆脂瘤型中耳炎患者，试验组25例：采用耳内镜下双人操作方法行完壁式鼓室成形术，对照组20例，采用传统显微镜下操作行开放式乳突根治+鼓室成形术，术后对两组干耳时间及听力结果进行比较。结果：试验组与对照组干耳时间分别是（20.4±4.6）d及（27.75±4.7）d，两组比较，差异有统计学意义（P<0.05），术后3月两组气骨导听阈的差值平均缩小了（16.1±2.5）dB及（11.95±1.9）dB，两组比较，差异有统计学意义（P<0.05）。所有患者术后随访1年，未见鼓膜内陷袋形成及胆脂瘤复发者。结论：耳内镜下双人操作完壁式鼓室成形术治疗慢性中耳炎，使手术更加微创，能最大限度的保存中耳的生理结构，术后干耳时间缩短，听力得到良好的恢复，值得临床推广应用。%Objective To explore the value of the operation in four hands for two men treating otitis media cholesteatomatica with closed tympanoplasties on otoendoscopic. Method 25 patients( ears)of otitis media cholesteatomatica were treated,surgery were operated in four hands for two men with closed tympanoplasties on otoendoscopic,there were 20 cases in control group who only accepted the treatment on mi-croscope,and then the clinical effect of two groups were compared. Results The time of dry ear of treatment group was 20. 4 ± 4. 6 day and control group was 27. 75 ± 4. 7 day. After 3 mouths,the difference of audibility threshold between air condution and bone condution were re-duced 16. 1 ± 2. 5dB for treatment group and 11. 95 ± 1. 9dB for control group. There were significant differences in the clinical effect between the two groups( P<0. 05). Conclusion The operatation of four hands for two men treating otitis media cholesteatomatica on otoendoscopic a-chieved the surgery more minimally invasive,preserved physiological structure of the middle ear and improved hearing after surgery.
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