Ghani A, Smith M C F
Department of Otolaryngology Head and Neck Surgery, Worcester Hospital, UK.
J Laryngol Otol. 2013 Dec;127(12):1160-8. doi: 10.1017/S002221511300248X. Epub 2013 Nov 19.
To evaluate the primary and long-term surgical outcomes of patients with postinflammatory medial meatal fibrosis.
A retrospective study was conducted of 14 ears (in 12 patients) with postinflammatory medial meatal fibrosis managed surgically. Outcome measures were primary (i.e. less than six months) and long-term (i.e. greater than five years) closure of the air-bone gap, and the incidence of otorrhoea and restenosis.
At primary review, the mean air-bone gap ± standard deviation had decreased from 29.9 ± 11.6 dB to 12 ± 8.4 dB (p < 0.0006). Seven (50 per cent) ears had closure of the air-bone gap to within 10 dB. However, for the 9 ears receiving long-term review, the mean air-bone gap ± standard deviation increased to 19.3 ± 15.2 dB; there was no significant difference between this result and pre-operative values (p = 0.06). Of the 9 long-term review ears, 3 (33 per cent) showed closure of the air-bone gap to within 10 dB. Recurrent otorrhoea was the most common complication, occurring in 5 of the 9 long-term review ears (56 per cent); in addition, 3 (33 per cent) of these 9 ears developed restenosis.
Over time, the success of surgery for postinflammatory medial meatal fibrosis diminishes. This was demonstrated in the present study by progressive post-operative hearing decline and a high prevalence of otorrhoea and restenosis.
评估炎症后耳道内侧纤维化患者的初次手术及长期手术效果。
对12例患者的14只耳朵进行了炎症后耳道内侧纤维化手术治疗的回顾性研究。观察指标为初次（即术后不到6个月）和长期（即术后超过5年）气骨导差的闭合情况、耳漏及再狭窄的发生率。
初次复查时，气骨导差的均值±标准差从29.9±11.6 dB降至12±8.4 dB（p<0.0006）。7只耳朵（50%）的气骨导差闭合至10 dB以内。然而，在接受长期复查的9只耳朵中，气骨导差的均值±标准差增至19.3±15.2 dB；该结果与术前值之间无显著差异（p = 0.06）。在接受长期复查的9只耳朵中，3只（33%）的气骨导差闭合至10 dB以内。复发性耳漏是最常见的并发症，在接受长期复查的9只耳朵中有5只出现（56%）；此外，这9只耳朵中有3只（33%）发生了再狭窄。
随着时间推移，炎症后耳道内侧纤维化手术的成功率降低。本研究通过术后听力逐渐下降以及耳漏和再狭窄的高发生率证实了这一点。
