ORM联合耳甲腔成形术、乳突腔填充术治疗中耳胆脂瘤的价值分析

摘要

Objective:To investigate the value of open radical mas-toidectomy (ORM) combined with auricular cavity angioplasty for the treatment of middle ear cholesteatoma.Method:A retrospective analysis of 60 patients with middle ear cholesteatoma undergoing radical surgery in our hospital from June 2014 to July 2017.All patients were divided into ORM group (n=31) and combined group (n=29) according to surgical methods.The ORM group was treated with ORM alone, and the combined group was given ORM combined with ear cavityplasty and mastoid cavity filling.The postoperative treatment effects, ear canal and corresponding structural recovery, hearing and postoperative hearing, complications, and middle ear cholesteatoma recurrence rate within 1 year of follow-up were compared between the two groups.Result:The total effective rate in the combined group was significantly higher than that in the ORM group (P＜0.05).The dry ear rate and tympanic membrane survival rate in the combined group were significantly higher than those in the ORM group, the dry ear time and ear canal epithelialization time were significantly shorter than those in the ORM group (P＜0.05) ;PTA and ABG in the combined group were significantly lower than those in the ORM group at 6 months after operation (P＜0.05).There was no statistically significant difference in the incidence of postoperative complications between the two groups (P＞0.05).The recurrence rate in the combined group was significantly lower than that in the ORM group (x2=4.251, P＜0.05).Conclusion:ORM combined with auricular cavityplasty and mastoid cavity filling for the treatment of middle ear cholesteatoma is effective, and can promote the healing of the ear canal related structure, improve the hearing and reduce the recurrence rate, the security is relatively good.%目的:探讨开放式乳突根治术 (open radical mas-toidectomy, ORM) 联合耳甲腔成形术、乳突腔填充术治疗中耳胆脂瘤的价值.方法:回顾性分析2014年6月-2017年7月于本院确诊并行中耳胆脂瘤根治术患者60例, 按照手术方式将患者分为ORM组 (n=31) 及联合组 (n=29), 其中ORM组手术方式为单纯ORM治疗, 而联合组给予ORM联合耳甲腔成形术及乳突腔填充术, 比较两组患者术后治疗效果、耳道及相应结构恢复情况、手术前后听力情况、并发症发生情况及随访1年内中耳胆脂瘤复发率的差异.结果:联合组患者治疗总有效率显著高于ORM组 (P＜0.05) ;联合组患者干耳率及鼓膜存活率均显著高于ORM组, 干耳时间及耳道上皮化时间均显著短于ORM组 (P＜0.05) ;联合组术后6个月PTA及ABG均显著低于ORM组 (P＜0.05) ;两组患者术后并发症发生率比较, 差异无统计学意义 (P＞0.05) ;联合组患者术后复发率显著低于ORM组 (字2=4.251, P＜0.05) .结论:ORM联合耳甲腔成形术、乳突腔填充术治疗中耳胆脂瘤效果较好, 且能促进患者术后耳道相关结构愈合, 同时改善其听力情况, 降低术后复发率, 且安全性相对较好.