Dornhoffer J L
Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock 72205, USA.
Otolaryngol Head Neck Surg. 1999 Mar;120(3):361-7. doi: 10.1016/S0194-5998(99)70276-7.
This retrospective study used a computerized otologic database to identify patients undergoing revision surgery for a draining cavity unresponsive to medical therapy, with at least a 2-year follow-up. The surgical intervention involved partial mastoid obliteration and restoration of the middle ear space by use of cartilage reconstruction of the tympanic membrane. Ossicular reconstruction was achieved with either a partial or total ossicular replacement prosthesis. Because this technique involved contouring the mastoid cavity, the problems that usually occur, such as drainage or debris collection, were alleviated. In addition, re-establishment of the middle ear space often restored hearing. A completely dry cavity was achieved in 18 of 20 patients. An overall statistically significant improvement in hearing (P < 0.05) was obtained, with the mean pure-tone average air-bone gap decreasing to 16.1 dB from 36.5 dB. This technique has proven to be a useful adjunct in the surgical management of the chronically draining cavity.
这项回顾性研究使用计算机化耳科数据库，以识别因引流腔对药物治疗无反应而接受翻修手术且至少随访2年的患者。手术干预包括部分乳突填塞，并通过鼓膜软骨重建来恢复中耳空间。听骨链重建采用部分或全听骨置换假体。由于该技术涉及对乳突腔进行塑形，因此通常出现的引流或碎屑积聚等问题得到缓解。此外，中耳空间的重建常常能恢复听力。20例患者中有18例实现了完全干燥的术腔。听力总体上有统计学意义的改善（P<0.05），平均纯音气骨导差从36.5dB降至16.1dB。该技术已被证明是慢性引流腔手术治疗中的一种有用辅助手段。
