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锤骨柄被鳞状上皮包绕、上鼓室胆脂瘤、鼓膜紧张部被鳞状上皮侵犯、锤骨发生粘连或鼓室硬化症不能松动时,皆应将锤骨柄去除。锤骨柄的丧失对重建手术产生许多问题。锤骨柄存在时可在锤骨柄与镫骨或底板间置放骨柱重建听骨链,手术既简便、小柱无穿出危险、且可获得良好听力。本文介绍三种术式以解决锤骨消失后存在的问题:1.锤骨旁路法:在镫骨或底板与筋膜间安装小柱,此法易发生脱位或穿出,远期疗效差。2.异体移植:骨性外耳道完整者,可移植异体鼓膜与听骨,然而材料不易获得,且穿孔率较
Stems are surrounded by squamous epithelium, cholecystitis on the tympanic membrane, tympanic membrane tension was squamous epithelial invasion, mastoid adhesions or tympanosclerosis can not be loose, should remove the malleus. Loss of the malleus stems from many problems with reconstructive surgery. The existence of malleus handle can be placed in the mastiff between the mastiff and the stapes or floor to rebuild the ossicular chain, the operation is simple, small column without perforation risk, and get good hearing. This article describes three kinds of surgical procedures to solve the problems after the disappearance of malleus: 1. Muck bypass method: the stapes or floor and fascia between the installation of small columns, this method prone to dislocation or piercing, long-term poor efficacy . 2. Allograft: Complete external auditory canal, transplanted allogeneic tympanic membrane and the ossicles, but the material is not easy to obtain, and the perforation rate than