Meyerhoff W L, Pollock K J, Roland P S, Mickey B
Department of Otorhinolaryngology, University of Texas Southwestern Medical Center--Dallas 75235-9035.
Otolaryngol Head Neck Surg. 1991 Jan;104(1):100-2. doi: 10.1177/019459989110400118.
Spinal fluid otorrhea and otorhinorrhea are morbid complications that occur in up to 18% of patients after removal of translabyrinthine tumor. Both of these problems can be significantly reduced if, during the initial surgery, the posterior canal wall is taken down and the tympanic membrane and external auditory canal skin are removed for better exposure of the eustachian tube orifice. The external auditory meatus can then be sealed by a previously described modification of the Rambo procedure. This additional procedure adds about 20 minutes to the surgery and presents a small risk of retained squamous epithelium. Fifty consecutive patients were divided into two equal groups and studied retrospectively. In group I, the patients underwent a modified Rambo meatoplasty at the time of the removal of their translabyrinthine tumor, whereas patients in group II had the tympanic orifice of their eustachian tube obstructed through the facial recess. Review of the postoperative course of these fifty patients indicated that the addition of the modified Rambo meatoplasty was justified by the overall reduction in morbidity and expense it provided.
脑脊液耳漏和耳鼻漏是经迷路肿瘤切除术后高达18%的患者会出现的病态并发症。如果在初次手术期间取下后耳道壁并切除鼓膜和外耳道皮肤以更好地暴露咽鼓管开口，这两个问题都可以显著减少。然后可以通过先前描述的改良兰博手术来封闭外耳道。这个额外的手术会使手术时间增加约20分钟，并且存在残留鳞状上皮的小风险。连续50例患者被分成两组进行回顾性研究。在第一组中，患者在经迷路肿瘤切除时接受改良兰博外耳道成形术，而第二组患者的咽鼓管鼓膜口则通过面神经隐窝阻塞。对这50例患者术后病程的回顾表明，改良兰博外耳道成形术因其总体上降低了发病率和费用而具有合理性。
