Hildmann H
HNO-Klinik, St. Elisabeth-Hospital Bochum.
HNO. 1991 Feb;39(2):43-7.
Recurrent middle ear disease may carry a high probability of complications, and there is no doubt of the necessity of revision surgery for either cholesteatoma or tumor. However, failures in function should be individually analyzed before a second procedure is decided upon. A pre-requisite for surgical improvement of hearing is adequate tubal and inner ear function. Chronic suppurative otitis media has a higher tendency for reperforation than cholesteatoma. Adhesive otitis indicates poor tubal function. Tympanosclerosis may cause refixation requiring stapedectomy at a second stage. Middle ear fibrosis recurs in about 50% of cases. Post-operative failures such as extrusion of ossicles, lateralization of the tympanic membrane, and blunting of the anterior tympanomeatal angle as well as failures after stapes surgery are discussed.
复发性中耳疾病可能伴有较高的并发症发生概率，对于胆脂瘤或肿瘤而言，二次手术的必要性毋庸置疑。然而，在决定进行二次手术之前，应单独分析功能失败的情况。手术改善听力的一个先决条件是咽鼓管和内耳功能良好。慢性化脓性中耳炎比胆脂瘤更容易再次穿孔。粘连性中耳炎表明咽鼓管功能不良。鼓室硬化症可能导致再次固定，需要在第二阶段进行镫骨切除术。中耳纤维化在约50%的病例中会复发。文中讨论了术后失败情况，如听小骨脱出、鼓膜外移、鼓室前鼓室角变钝以及镫骨手术后的失败情况。
