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目的:总结炎性迷路瘘管的手术治疗经验。方法:回顾分析手术修复迷路瘘管23例的临床资料。均清除胆脂瘤基质及瘘管周围炎性病变,<2 mm的瘘管7例单用筋膜覆盖;2～3 mm的瘘管13例用小骨片填塞,外盖筋膜;>3 mm的3例瘘管用筋膜填塞瘘管两端骨管腔内,以骨片及筋膜填塞瘘管。结果:23例中,术后2例失访,余21例平均随访2.5年,19例干耳,17例眩晕消失;除术前2例全聋外,19例术后语频气导69.1 dB HL,骨导30.6 dB HL。结论:除瘘管试验外,术前岩骨轴位CT扫描有重要诊断价值。由于上下迷路之间的解剖屏障和炎性分隔,手术封闭迷路瘘管是可行的。手术成功关键是精湛的耳显微手术技巧,彻底清除病灶,可靠封闭或填塞瘘管,辅以抗炎及类固醇治疗,坚持术后治理。
Objective: To summarize the experience of surgical treatment of inflammatory labyrinth fistula. Methods: Retrospective analysis of 23 cases of labyrinthine fistula repair surgery. 7 cases of fistula less than 2 mm were covered with fascia alone, 13 cases of 2 to 3 mm fistula were filled with small bones, the fascia of outer cover and 3 cases of> 3 mm Fistula Fistula with fistula at both ends of the bone cavity, to fill the fistula and fascia. Results: Of the 23 cases, 2 cases were lost to follow-up, 21 cases were followed up for an average of 2.5 years, 19 cases were dry ears and 17 cases were vertigo disappeared. Except 2 cases before total deafness, 19 cases had postoperative audio guidance 69.1 dB HL, bone conduction 30.6 dB HL. Conclusion: In addition to fistula test, preoperative osteotomy axial CT scan has important diagnostic value. Because of the anatomical barrier and inflammatory separation between the lost and the lost, surgical closure of the lost fistula is feasible. The key to successful operation is superb ear microsurgery techniques, complete removal of the lesion, reliable closure or stuffing fistula, supplemented by anti-inflammatory and steroid treatment, adhere to postoperative management.