Goyal Rashmi, Mourya Ashish, Qureshi Sadat, Sharma Sandeep
Department of ENT, PCMS & RC Bhopal, Bhopal, India.
Indian J Otolaryngol Head Neck Surg. 2016 Mar;68(1):52-5. doi: 10.1007/s12070-015-0890-z. Epub 2015 Aug 22.
Chronic suppurative otitis media with cholesteatoma is a fairly common condition presenting in any ENT clinic and its surgery remains one of the most challenging surgeries in otology. The primary goal of cholesteatoma surgery is to clear the disease and produce a safe and stable ear but there is still debate on whether these goals are best achieved by canal wall down or canal wall up procedures. A retrospective study was done to access benefits of modified radical mastoidectomy (MRM) with type III tympanoplasty in terms of eradication of disease and hearing improvement. It consisted of 140 patients of chronic otitis media (attico-antral) who underwent MRM with type III tympanoplasty in 156 ears in a tertiary care centre. Temporalis fascia graft was used for tympanoplasty. Results were analyzed in terms of condition of cavity, condition of graft and gain in hearing. The study showed significant improvement in gain in air conduction (21.24 dB) and closure of AB gap (15.62 dB). In the Indian population with low socio-economic status and poor follow up, single stage canal wall down procedure (MRM) provides maximum benefit to patients in terms of eradication of disease and hearing improvement.
慢性化脓性中耳炎伴胆脂瘤是任何耳鼻喉科诊所中较为常见的病症，其手术仍是耳科学中最具挑战性的手术之一。胆脂瘤手术的主要目标是清除病灶并使耳部安全稳定，但对于通过开放式或完壁式手术能否最佳地实现这些目标仍存在争议。进行了一项回顾性研究，以评估改良乳突根治术（MRM）联合III型鼓室成形术在根除疾病和改善听力方面的益处。该研究包括140例慢性中耳炎（上鼓室-鼓窦型）患者，他们在一家三级医疗中心接受了156耳的MRM联合III型鼓室成形术。采用颞肌筋膜移植进行鼓室成形术。根据术腔情况、移植物情况和听力增益对结果进行分析。研究表明气导增益（21.24dB）和AB间隙闭合（15.62dB）有显著改善。在社会经济地位较低且随访不佳的印度人群中，单阶段开放式手术（MRM）在根除疾病和改善听力方面为患者提供了最大益处。
