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[颞骨病理学中的外侧岩骨切除术]

[Lateral petrosectomy in pathology of the temporal bone].

作者信息

Bartoszewicz Robert, Niemczyk Kazimierz, Morawski Krzysztof, Bruzgielewicz Antoni, Sokołowski Jacek

机构信息

Katedra i Klinika Otolaryngologii Warszawskiego Uniwersytetu Medycznego.

出版信息

Otolaryngol Pol. 2010 Jun;64(7):81-6. doi: 10.1016/S0030-6657(10)70016-0.

DOI:10.1016/S0030-6657(10)70016-0
PMID:21171318
Abstract

INTRODUCTION

Certain problems in ear surgery are caused by temporal bone cholestetoma and chronic otitis media complicated by deafness, facial nerve dysfunction, vertigo or meningcephalocele. Lateral petrosectomy offers possibility of radical treatment and prevention of temporal bone destruction and following complications.

AIM OF STUDY

It is an analysis of indications for lateral petrosectomy and it's results as a treatment of otitis media and temporal bone cholesteatoma. The possibility of synchronous cochlear implantation is noted.

MATERIAL

Retrospective analysis of 62 patients after lateral petrosectomy, operated in the Department of Otolaryngology at the Medical University of Warsaw in 2001-2009. The group consisted of thirty one men and thirty one women.

RESULTS

Thirty two patients suffered from chronic granuloma or chronic choleateatoma otitis media or temporal bone cholesteatoma. Seventeen patients suffered from deafness prior surgery. Cochlear implantation was possible in five patients: two of them after cranium fracture, two with deafness caused by chronic otitis media and one with deafness caused by osteoradionecrosis. Intraoperative CSF leak was observed of eight patients. In one case lateral perosectomy was used as a treatment of CSF leak after removal of cerebellopontine tumor. There was no evidence of CSF leak after surgery. Facial nerve dysfunction was observed in fifteen cases.

CONCLUSIONS

Lateral petrosectomy offers possibility of radical treatment in same patients with chronic otorrhea. The total removal of cholesteatoma prevents intracranial and intratemporal complications in case of chronic otitis media. Patients after lateral petrosectomy require systematic ENT and radiological (CT, NMR) examination.

摘要

引言

耳外科的某些问题是由颞骨胆脂瘤和慢性中耳炎并发耳聋、面神经功能障碍、眩晕或脑膜脑膨出引起的。岩骨外侧切除术为根治性治疗以及预防颞骨破坏和后续并发症提供了可能。

研究目的

分析岩骨外侧切除术的适应证及其作为治疗中耳炎和颞骨胆脂瘤的效果。记录同期进行人工耳蜗植入的可能性。

材料

对2001年至2009年在华沙医科大学耳鼻喉科接受岩骨外侧切除术的62例患者进行回顾性分析。该组包括31名男性和31名女性。

结果

32例患者患有慢性肉芽肿性或慢性胆脂瘤性中耳炎或颞骨胆脂瘤。17例患者在手术前患有耳聋。5例患者可行人工耳蜗植入:其中2例在颅骨骨折后,2例因慢性中耳炎导致耳聋,1例因放射性骨坏死导致耳聋。8例患者术中观察到脑脊液漏。1例在切除桥小脑角肿瘤后,采用岩骨外侧切除术治疗脑脊液漏。术后无脑脊液漏迹象。15例患者观察到面神经功能障碍。

结论

岩骨外侧切除术为部分慢性耳漏患者提供了根治性治疗的可能。胆脂瘤的完全切除可预防慢性中耳炎患者发生颅内和颞内并发症。岩骨外侧切除术后的患者需要进行系统的耳鼻喉科和放射学(CT、核磁共振)检查。

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