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使用双相陶瓷颗粒在开放式乳突切除术的修复中的应用。

Use of granules of biphasic ceramic in rehabilitation of canal wall down mastoidectomy.

机构信息

ENT Department, AP-HP, Beaujon Hospital, 92110, Clichy, France,

出版信息

Eur Arch Otorhinolaryngol. 2014 Jan;271(1):59-64. doi: 10.1007/s00405-013-2393-4. Epub 2013 Feb 14.

Abstract

The objective of this study is to evaluate the anatomical and functional results of rehabilitation of canal wall down (CWD) mastoidectomy using granules of biphasic ceramic. This is a study design retrospective in a tertiary referral centre Fifty-seven patients (59 ears) operated on between 2006 and 2010 of mastoid obliteration with granules of biphasic ceramic (TricOs, Maurepas, France) have been included (55 revisions and 4 first surgeries). Forty-six patients presented already a CWD mastoidectomy. The mean pre-operative bone conduction (BC) was 29 ± 3.4 dB (mean ± SEM) and mean air conduction (AC) was 57 ± 3.2 dB. Cholesteatoma was found in 33 cases. All but seven cases had post-operative otoscopy examination at 1, 3, 6 months, and 1 year postoperative with a CT scan and pure tone audiometry. Mean follow-up was 14 ± 1.8 months (3-35). At one-year follow-up (n = 52), 47 cases (90 %) presented well-healed external auditory canal. Five cases (10 %) of uncovered granules without sign of infection of external auditory canal skin were observed. Mean post-operative threshold was 25 ± 1.8 and 46 ± 1.9 dB for BC and AC , respectively (n = 47). CT scan (n = 42) showed no opacity suggesting residual disease within or behind obliteration. Mastoid obliteration with granules of biphasic ceramic is a safe and effective procedure that allows restoration of a near normal external auditory canal.

摘要

本研究旨在评估使用双相陶瓷颗粒进行完壁式(CWD)乳突切除术后的解剖和功能结果。这是一项回顾性的三级转诊中心研究设计,共纳入了 57 例(59 耳)于 2006 年至 2010 年间接受双相陶瓷颗粒(TricOs,Maurepas,法国)乳突填塞术的患者(55 例为翻修手术,4 例为初次手术)。46 例患者已行 CWD 乳突切除术。术前平均骨导(BC)为 29 ± 3.4dB(平均值 ± SEM),平均气导(AC)为 57 ± 3.2dB。33 例患者发现胆脂瘤。除 7 例外,所有患者均在术后 1、3、6 个月和 1 年进行了术后耳镜检查、CT 扫描和纯音听阈测试。平均随访时间为 14 ± 1.8 个月(3-35 个月)。在一年的随访中(n=52),47 例(90%)患者的外耳道愈合良好。观察到 5 例(10%)无覆盖的陶瓷颗粒,但外耳道口皮肤无感染迹象。47 例患者术后 BC 和 AC 的平均阈值分别为 25 ± 1.8dB 和 46 ± 1.9dB(n=47)。CT 扫描(n=42)显示无混浊,提示填塞物内或后面无残留病变。使用双相陶瓷颗粒进行乳突填塞术是一种安全有效的方法,可恢复接近正常的外耳道。

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