Geerse S, Ebbens F A, de Wolf M J F, van Spronsen E
Department of Otorhinolaryngology,Academic Medical Center,Amsterdam,the Netherlands.
J Laryngol Otol. 2017 Feb;131(2):138-143. doi: 10.1017/S002221511600997X. Epub 2017 Jan 10.
This study aimed to evaluate the results of revision radical cavity surgery with mastoid obliteration using a standardised grading scheme.
A retrospective study was performed of 121 patients (122 ears) with chronically draining ears who underwent revision radical cavity surgery with mastoid obliteration between 2007 and 2013. Surgical indications, patient characteristics, pre- and post-operative Merchant grade, and surgical outcomes were recorded. The main outcome measures were presence of a dry ear, time for complete re-epithelialisation, presence of residual or recurrent disease, and need for revision surgery.
In the 5-year follow-up group (n = 31), dry ears were found in 97 per cent after 6 minor revisions and cholesteatoma-free ears were found in 97 per cent. In the total cohort, dry ears were found in 93 per cent after nine revisions and cholesteatoma-free ears were found in 98 per cent. The median time for complete re-epithelialisation was eight weeks. There were no major complications.
In terms of the dry ear rate, residual cholesteatoma and time to complete epithelialisation, revision radical cavity surgery with mastoid obliteration produces very good results in concordance with published results, despite most patients suffering from very troublesome cavities prior to surgery.
本研究旨在使用标准化分级方案评估乳突切除改良根治性中耳手术的结果。
对2007年至2013年间接受乳突切除改良根治性中耳手术的121例(122耳)慢性耳漏患者进行回顾性研究。记录手术指征、患者特征、术前和术后Merchant分级以及手术结果。主要观察指标为干耳情况、完全上皮化时间、残留或复发性疾病情况以及再次手术的必要性。
在5年随访组(n = 31)中,经过6次小的修正后,97%的患者出现干耳,97%的患者耳内无胆脂瘤。在整个队列中,经过9次修正后,93%的患者出现干耳,98%的患者耳内无胆脂瘤。完全上皮化的中位时间为8周。无重大并发症。
就干耳率、残留胆脂瘤和完全上皮化时间而言,尽管大多数患者术前中耳腔问题严重,但乳突切除改良根治性中耳手术的效果与已发表的结果一致,非常良好。