Bulğurcu Suphi, Arslan İlker Burak, Dikilitaş Bünyamin, Çukurova İbrahim
Department of Otorhinolaryngology, Başkale State Hospital, Van, Turkey.
Department of Otorhinolaryngology, Tepecik Training and Research Hospital, Izmir, Turkey.
Int Arch Otorhinolaryngol. 2017 Jul;21(3):239-242. doi: 10.1055/s-0036-1592417. Epub 2016 Sep 14.
Chronic otitis media can cause multiple middle ear pathogeneses. The surgeon should be aware of relation between ossicular chain erosion and other destructions because of the possibility of complications. This study aimed to investigate the rates of ossicular erosion in cases of patients with and without facial nerve canal destruction, who had undergone mastoidectomy due to chronic otitis media with or without cholesteatoma. We retrospectively analyzed three hundred twenty-seven patients who had undergone tympanomastoidectomy between April 2008 and February 2014. We documented the types of mastoidectomy (canal wall up, canal wall down, and radical mastoidectomy), erosion of the malleus, incus and stapes, and the destruction of facial and lateral semi-circular canal. Out of the 327 patients, 147 were women (44.95%) and 180 were men (55.04%) with a mean age 50.8 ± 13 years (range 8-72 years). 245 of the 327 patients (75.22%) had been operated with the diagnosis of chronic otitis media with cholesteatoma. FNCD was present in 62 of the 327 patients (18.96%) and 49 of these 62 (79.03%) patients had chronic otitis media with cholesteatoma. The correlation between the presence of FNCD with LSCC destruction and stapes erosion in chronic otitis media with cholesteatoma is statistically significant ( < 0.05). Although incus is the most common of destructed ossicles in chronic otitis media, facial canal destruction is more closely related to stapes erosion.
慢性中耳炎可导致多种中耳病变。由于存在并发症的可能性,外科医生应了解听骨链侵蚀与其他破坏之间的关系。 本研究旨在调查因慢性中耳炎伴或不伴胆脂瘤而接受乳突切除术的患者中,有或无面神经管破坏的病例的听骨侵蚀率。 我们回顾性分析了2008年4月至2014年2月期间接受鼓室乳突切除术的327例患者。我们记录了乳突切除术的类型(开放式、完壁式和根治性乳突切除术)、锤骨、砧骨和镫骨的侵蚀情况,以及面神经和外侧半规管的破坏情况。 在327例患者中,女性147例(44.95%),男性180例(55.04%),平均年龄50.8±13岁(范围8 - 72岁)。327例患者中有245例(75.22%)因慢性中耳炎伴胆脂瘤而接受手术。327例患者中有62例(18.96%)存在面神经管破坏,其中62例中的49例(79.03%)患有慢性中耳炎伴胆脂瘤。在慢性中耳炎伴胆脂瘤中,面神经管破坏的存在与外侧半规管破坏和镫骨侵蚀之间的相关性具有统计学意义(<0.05)。 虽然在慢性中耳炎中砧骨是最常被破坏的听小骨,但面神经管破坏与镫骨侵蚀的关系更为密切。