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作者自1955年至1958年共为326个病人进行了337次鼓室成形手术,本文报道其中250例(256次)的远期疗效(观察时間为1—4年)。手术采用Wulletein氏方法,大多数患者的游离皮瓣取自耳后区。有34例慢性化脓性上鼓室炎的病者做了修建大鼓室腔的手术(凿开鼓隐窝与鼓竇)。根据所获得的良好疗效和从解剖学与听功能的观点上来看,这是一种最保守和最有效的鼓室成形手术,但祇适于慢性化脓性上鼓室炎鼓室內的結构未遭到大的破坏时进行。作者认为术后的听力变化与术前的听力状况无关。还指出皮瓣生长能力弱的地方通常是在鼓室腔处(得不到足够的营养所致)。 10例慢性化脓性中,上鼓室炎与3例过去曾做过耳根治手术而有听力显著降低。耳內继續流脓的患者做了小鼓室修建与迷路开窗手术。从远期結果来看,大部份患者的听力均降至术前的水平。 76例听骨鏈有破坏(镫骨存在)的患者做了耳根治手术和修建小鼓室腔。残存的听骨可作为皮瓣的支撑点,
The author conducted 337 tympanoplasty procedures for 326 patients from 1955 to 1958, of which 250 cases (256) were reported for long-term efficacy (observation duration 1-4 years). Wulletein’s procedure was used for surgery, and the majority of patients had free flaps taken from the posterior region of the ear. Thirty-four patients with chronic suppurative upper-class tympanitis were given surgery to create the tympanic cavity (chipping the drum’s crypt and the sinuses). This is one of the most conservative and effective tympanoplasty procedures, based on good efficacy achieved and from the anatomical and auditory perspectives, but only for structures in the chronic suppurative supra-tympanitis chamber that are not subject to significant The destruction of the time. The author believes that postoperative changes in hearing have nothing to do with preoperative hearing. Also pointed out that the weakness of flap growth is usually in the tympanic cavity (not enough nutrition). Ten cases of chronic suppurative middle and upper tympanitis and three cases of past auricular surgery had hearing loss significantly reduced. The ear continued pus in patients with a small tympanum construction and lost open window surgery. From the long-term results, most of the patients hearing dropped to the preoperative level. Sixty-six patients with dislodged ossicular chain (tarsal bone) underwent radical mastectomy and reconstruction of the bongoosus. Residual ossicles can be used as a support point for the flap,