论文部分内容阅读
作者曾对一组难治的梅尼埃病患者行内淋巴囊补偿手术(endolymphotic sac ellhancement,指经乳突内淋巴囊引流术,并用硅胶制品插入内淋巴囊内和隔开硬脑膜及半规管骨膜。见Ann Otol Rhinol Laryngol·-1981,90·-610～615—摘者),取得了良好效果。但其中26例(4％)分别在6个月至11年(平均2.6年)后,症状再度发展,22例发作眩晕和耳聋,4例单纯耳聋。作者对这些患者又施行了内淋巴囊修正术,术中所有病例都发现囊区有新骨形成和瘢痕组织,前者多来源于邻近侧窦处和迷路下气房群;有些患者是由于第一次手术时骨质去除不够充分;不少患者还发现鼓窦入口堵塞,有的在乳突腔内存在较多新生组织。作者认为以上所见乃是症状复发的原因。于是采取了修正措施,包括:(1)妥善处理创口,切口远离耳后1英寸以上,避免切口跨越乳突腔以防血液流入而形成瘢痕和肉芽组织;(2)进行彻底的乳突凿开术,广泛暴露侧窦,使淋巴囊得到充分减压,特别是对第一次手术减
The authors have performed a series of endolymphotic sac ellhancements on a group of patients with refractory Meniere’s disease who underwent endolymphatic drainage of the mastoid and were inserted into the endolymphatic sac using a silicone product and separated from the dura and semicircular canals. See Ann Otol Rhinol Laryngol-1981,90 -610 ~ 615-pick), and achieved good results. However, 26 (4%) of them developed symptoms again after 6 months to 11 years (average 2.6 years), with 22 cases of vertigo and deafness and 4 cases of simple deafness. The authors performed an endolymphatic sac revision in these patients. All cases were found to have new bone formation and scar tissue in the area. The former mostly originated from adjacent sinuses and labyrinthine air spaces; some patients were due to the first During the operation, bone removal was not sufficient; many patients also found that the entrance of the sinuses was blocked, and some had more new tissues in the mastoid cavity. The authors believe that the above is the reason for the recurrence of symptoms. Therefore, corrective measures were taken, including: (1) proper treatment of the incision, incision more than 1 inch away from the ear, to avoid incision across the mastoid cavity to prevent blood flow to form scar and granulation tissue; (2) Surgery, extensive exposure of the lateral sinuses, the lymphatic sac to obtain adequate decompression, especially for the first operation by