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慢性中耳炎,尤其是胆脂瘤常引起砧骨长突缺失,必须作听骨链再建手术。如病变只影响砧骨,虽听骨链中断,而槌骨、镫骨尚完整者,可用槌镫连接术治疗。其法是先完成乳突凿开,并按照乳突病变程度,外耳道后壁及骨桥可去除(开放型)或保留(封闭型)。若鼓膜已接近全部缺失,则连同鼓环一起去除;若仅为小穿孔,则予保留,小心去除鼓室,尤其是镫骨周围的肉芽组织。用一精细钩子将槌骨头从上鼓室钩出,当心勿使槌骨与鼓膜张肌腱脱开。按右耳逆时针,左耳顺时针方向轻轻旋转槌骨,并轻拉几下则槌头易于与镫头接触。彻底清除上鼓室肉芽。
Chronic otitis media, especially cholesteatoma, often causes an incus oblonga loss and must be reconstructed for ossicular chain surgery. If the lesion affects the incus, although the interruption of the chain hearing, and the mallet, tarsal bone is still intact, can be treated with hammer 镫 connection. The method is to complete the mastoid hesitated first, and in accordance with the degree of papillary lesions, the posterior wall of the external auditory canal and the bridge can be removed (open type) or reserved (closed type). If the tympanic membrane is nearly completely absent, remove it together with the drum ring; if it is only small, keep it, and carefully remove the tympanic cavity, especially the granulation tissue around the stapes. Use a fine hook to hook the hammerhead from the upper drum, taking care not to break the hammerbone and tympanic tendon. Press the right ear anti-clockwise, the left ear clockwise rotation of the hammer, and gently pull a few times the hammer head easy to contact with the nipple. Thoroughly clear the upper chamber granulation.