Objective:To approach effective that open radical mastoidectomy in two kinds of Operation Approach through behind the ears and in ears.Method:Treating sixty ears which were Cholesteatoma otitis media by mastoid contour through behind the ears approach+conchal cavity forming technique,and comparing with forty ears which were traditional radical mastoidectomy+skin graft in through in the ears.Visiting 6-24 months.Result:Dry ear rate was 90%in first method,Dry ear rate was 60%in second method,the first method was more than the second method.The fewer had complication and the low rate of return in the first method.Two methods had no significant difference in improving hearing situation after operation.Conclusion:Mastoid contour through behind the ears approach+conchal cavity forming technique is a safer,more reasonable and effective method to effect a radical cure of Cholesteatoma otitis media.% 目的：探讨经耳后及耳内两种进路下开放式乳突根治术的疗效.方法：以耳后进路乳突轮廓化+耳甲腔成型术治疗胆脂瘤型中耳炎60耳，并与同期行耳内进路传统乳突根治术+替氏植皮术的40耳进行疗效比较.随访时间6~24个月.结果：耳后组术后最后干耳率为90.0%，明显高于耳内组的60.0%，前者术时并发症发生率及术后复诊率较低.两组术后听力改善情况无明显差异.结论：耳后进路乳突根治术+耳甲腔成型术是一种更安全、合理、有效的根治胆脂瘤型中耳炎并获干洁自净术腔的方法.
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