鼓室乳突切除术：慢性中耳炎手术中开放式与完壁式技术的比较
Tympanomastoidectomy: Comparison between canal wall-down and canal wall-up techniques in surgery for chronic otitis media.
作者信息
Azevedo Alexandre Fernandes de, Soares Anna Bárbara de Castro, Garchet Henrique Queiroz Correa, Sousa Nicodemos José Alves de
机构信息
MD in Infectology at the Federal University of Minas Gerais. Assistant Doctor - Otolaryngology Clinic of Santa Casa B.H.
Resident of Plastic Surgery at the Hospital Mater Dei.
出版信息
Int Arch Otorhinolaryngol. 2013 Jul;17(3):242-5. doi: 10.7162/S1809-97772013000300002.
INTRODUCTION
Chronic otitis media (COM) is an inflammatory condition associated with otorrhea as well as large and persistent perforations of the tympanic membrane in some cases. COM can also lead to cholesteatoma. Surgical treatment with canal wall-down and canal wall-up tympanomastoidectomy is considered for both types of illness. The choice of technique is controversial and is dependent on several factors, including the extent of disease.
OBJECTIVE
We aimed to evaluate surgical outcomes in COM patients with and without cholesteatoma treated with canal wall-down and canal wall-up tympanomastoidectomy. Disease eradication and post-operative auditory thresholds were assessed.
METHOD
Patient records from the otorhinolaryngology department of a tertiary hospital were assessed retrospectively.
RESULTS
Patients who underwent canal wall-up tympanomastoidectomy had a higher rate of revision surgery, especially those with cholesteatoma. However, there were no statistically significant differences in post-operative hearing thresholds between the two techniques.
CONCLUSION
The canal wall-down technique is superior to the canal wall-up technique, especially for patients with cholesteatoma.
引言
慢性中耳炎（COM）是一种炎症性疾病，伴有耳漏，在某些情况下还伴有鼓膜的大而持续性穿孔。COM还可导致胆脂瘤。对于这两种疾病，均考虑采用开放式和完壁式鼓室乳突切除术进行手术治疗。技术的选择存在争议，并且取决于几个因素，包括疾病的范围。
目的
我们旨在评估采用开放式和完壁式鼓室乳突切除术治疗的伴有和不伴有胆脂瘤的COM患者的手术结果。评估疾病根除情况和术后听觉阈值。
方法
对一家三级医院耳鼻喉科的患者记录进行回顾性评估。
结果
接受完壁式鼓室乳突切除术的患者翻修手术率较高，尤其是患有胆脂瘤的患者。然而，两种技术在术后听力阈值方面没有统计学上的显著差异。
结论
开放式技术优于完壁式技术，尤其是对于患有胆脂瘤的患者。
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