我们是否应该在鼓室成形术中切除锤骨柄尖？
Shall we resect the tip of manubrium mallei in tympanoplasty?
机构信息
Department of ENT, Ankara Ataturk Training and Research Hospital, Ankara, Turkey.
出版信息
Clin Exp Otorhinolaryngol. 2011 Mar;4(1):24-6. doi: 10.3342/ceo.2011.4.1.24. Epub 2011 Mar 17.
OBJECTIVES
In tympanoplasty operations if perforation is related with malleus handle, malleus handle is desepithelised. We planned this research to investigate whether the epithelial remnants remain as a result of this desepithelisation or not.
METHODS
The 35 patients who were performed tympanoplasty operation were divided into two groups. In the first group which included 13 patients the tip portion of manubrium mallei were cut off without desepithelisation. In the second group which included 22 patients the tip portions of manubrium mallei were cut off after the meticulous desepithelisation. The presence of squamous epithelium was examined histopathologically on the specimens.
RESULTS
Squamous epithelium was observed in 9 of the 13 non-desepithelised specimens and in 6 of 22 desepithelised specimens.
CONCLUSION
In tympanoplasty operations despite careful desepithelisation, squamous epithelial remnants may remain on the malleus handle. So the tip of manubrium mallei could be resected to prevent the future development of cholesteatoma.
目的
在鼓室成形术中，如果穿孔与锤骨柄有关，则对锤骨柄进行去上皮化处理。我们计划开展此项研究，以调查去上皮化后是否会留下上皮残余物。
方法
将 35 例行鼓室成形术的患者分为两组。在第一组（13 例）中，不进行去上皮化处理，直接切除锤骨柄的尖端部分。在第二组（22 例）中，在进行仔细的去上皮化处理后，切除锤骨柄的尖端部分。通过组织病理学检查标本，观察是否存在鳞状上皮。
结果
在未去上皮化的 13 个标本中，有 9 个标本观察到鳞状上皮，在去上皮化的 22 个标本中，有 6 个标本观察到鳞状上皮。
结论
尽管进行了仔细的去上皮化处理，在锤骨柄上仍可能残留鳞状上皮残余物。因此，可以切除锤骨柄的尖端部分，以防止胆脂瘤的进一步发展。
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