作者施行上鼓室胆脂瘤手术224例,随访3～16年。其中133耳行改良联合进路鼓室成形术,91耳作保守性乳突根治术及术腔填充术。手术均一次完成,有11%在随访期中重作手术。从胆脂瘤复发来看,二种手术无明显区别。高耳道后壁为6%;低耳道后壁为2%。高耳道后壁者发生内陷袋有38%,最后常形成小而静息的开放腔。手术方法如下:耳内切口至耳道前壁。作Rosen皮瓣,内止松弛部穿孔上缘,观察砧、镫骨。如同耳硬化症手术,去除后鼓环,可见整个后鼓室窦和镫骨底板。将该区病灶彻底清除,不必吝惜粘膜。作上鼓室窗,尽可能向前后扩大,但保留下缘的骨桥。上鼓室胆脂瘤能经此窗清理掉。常可同时见到槌前、后皱襞。作鼓窦开放术,保留外耳道后壁,将残存胆脂瘤除尽。后鼓室开 The authors performed 224 cases of tympanosarcoma on tympanosoma, followed up for 3 to 16 years. 133 ears improved tympanoplasty combined with tympanoplasty, 91 ears for conservative radical mastoidectomy and intraoperative filling. Surgery was completed at one time, and 11% underwent surgery during the follow-up period. Cholesteatoma recurrence from the point of view, no significant difference between the two kinds of surgery. High ear canal posterior wall is 6%; low ear canal posterior wall is 2%. There are 38% of the invagination bags in the posterior wall of the high ear canal, often resulting in small, resting open cavities. Surgical methods are as follows: ear canal incision to the anterior wall of the ear. Make Rosen flap, the innermost relaxation perforation on the edge, observe the anvil, stapes. As with otosclerosis surgery, removal of the posterior drum ring shows the entire posterior tympanic sinus and stapes floor. Thoroughly cleared the area, do not begrudge mucosa. Drum room windows, as far as possible to expand back and forth, but keep the lower edge of the bone bridge. Upper tympanic cholesteatoma can be cleared by this window. Often can see the hammer before, after the fold. For open sinus surgery, to retain the posterior wall of the external auditory meatus, the residual cholelithiasis removed. Rear drum open