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目的 :评估胆脂瘤根治术后Ⅰ期成形的效果。方法 :14 6例胆脂瘤根治后Ⅰ期鼓室成形中男 6 5例 ,女 81例 ,7～ 70岁 ,平均 4 0 .32岁 ;双侧耳 10例 ,共 15 6耳 ;占同期全部胆脂瘤手术 2 2 8耳的 6 7%。 16耳胆脂瘤复发 ,听力未提高 31耳 ,1～ 10年间均再次手术。随访 0 .5～ 10年 ,平均 3.1年。结果 :Ⅰ期手术后随访期内获得干耳14 6耳 (90 % ) ,16耳胆脂瘤复发 ,再次手术。 85耳术后气骨导差缩小 10dB以上 ,另 10耳手术前气骨导差小于10dB且气导在 4 0dB以内 ,术后听力仍保存 ,气骨导差没有扩大 ,此 95耳 (6 1% )为听力有效。另外 6 1耳中 16耳胆脂瘤复发 ,13耳鼓膜干性穿孔 (移植膜萎缩 ) ,2 2耳鼓膜塌陷、黏连 (咽鼓管通气不良 ) ,10耳戴帽的听骨太短与鼓膜连接不良。复发性胆脂瘤 16耳再手术后随访 0 .5年以上 ,全部获干耳并保持。再手术后 10耳 (6 3% )听力提高 10dB以上或保持在术前的 4 0dB水平以内。听力不良 31耳再手术后 2 6耳 (84 % )听力提高 10dB以上 ,随访0 .5年以上获得保持 ,另 5耳因咽鼓管功能不佳 ,鼓室黏连听力短暂提高后恢复至术前。结论 :胆脂瘤根治后Ⅰ期成形可使 6 1%的患耳听力改善 ,通过补救手术可使 84 %的患耳听力改善。成功与病灶范围、医生技术水平、中耳通气状况相关
Objective: To evaluate the effect of stage Ⅰ formation after cholesteatoma radical surgery. Methods: There were 65 males and 81 females with stage Ⅰ tympanoplasty in 14 6 cases of cholesteatoma, with an average of 40.32 years (range, 7 to 70 years). There were 10 bilateral ears in all, Cholesteatoma surgery 2 2 8 ears 6 7%. 16 ear cholesteatoma recurrence, hearing was not increased 31 ears, 1 to 10 years were re-operation. Follow-up 0.5 to 10 years, an average of 3.1 years. Results: A total of 14 6 ears (90%) of dry ears were obtained during the follow - up period after operation Ⅰ. The recurrence of 16 cases of cholesteatoma was achieved again. After the operation, the air-conduction difference of the 85 ear was reduced by more than 10 dB. The air-conduction difference of the other 10 ears was less than 10 dB and the air-guide was less than 40 dB. The postoperative hearing was still preserved and the air- %) For hearing effectively. In addition, 61 ear cholesteatoma recurrences, 13 eardrum dry perforations (atrophy of the graft membrane), 22 eardrum collapse, adhesions (eustachian tube dyspepsia) Poor connection. Recurrent cholesteatoma 16 ears were followed up for more than 0.5 years after surgery, all were dry ears and maintained. After reoperation, 10 ears (63%) improved their hearing more than 10 dB or kept the preoperative level of 40 dB. Hearing loss 31 ears after reoperation 26 ears (84%) Hearing increased by 10dB or more, followed up 0.5 years to maintain, and the other 5 ears due to eustachian tube dysfunction, tympanic adhesions hearing a brief increase after the return to preoperative . Conclusion: Stage Ⅰ of cholesteatoma can improve the hearing of 61% of the affected ears, and 84% of the affected ears can be remedied through remedial surgery. The success and extent of the disease, the doctor’s skill level, middle ear ventilation related