Huang J, Yang L, Wang J Y, Wang W Q
Department of Otolaryngology, Ningbo Donghai Hospital, Ningbo, 315040, China.
Department of Otolaryngology, Xinjiang Uygur Municipal People's Hospital.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Aug 20;31(16):1284-1287. doi: 10.13201/j.issn.1001-1781.2017.16.016.
The study aims to assess the effect of tympanoplasty without mastoidectomy for the middle ear under different infected states.One hundred and thirteen cases (113 ears) with chronic otitis media (COM) received tympanoplasty without mastoidectomy. All the patients were found inflammatory proliferative lesions in the mastoid and tympanic antrum via CT scan before surgery and were followed up over 1 year. The patients were placed into the infected ear group (72 ears) and uninfected ear group (41 ears) according to the infective condition. We used SPSS statistical software to analyze the efficacy.Of 113 cases, 92 ears had dry ear canals in 1/2 to 1 month after surgery, and the negative air pressure in the tympanum gradually disappeared in 3-6 months after surgery. Of the 72 ears in the infected ear group, 69 ears had postoperative dry ears, and a large amount of intraoperative purulent secretion was seen in the tympanum in 4 cases, which all had dry ear canals. Three cases had relapse, for a dry ear canal rate of 95.8%. Three ears showed dry tympanic membrane perforations, and effective ears with air-bone conduction differences smaller than or equal to 20 dB accounted for 51.4% of cases. Of the 41 ears in the uninfected group, 40 ears had postoperative dry ears, 1 case had relapse, for a dry ear canal rate of 97.6%. Two ears showed dry tympanic membrane perforations. Effective ears with air-bone conduction differences smaller than or equal to 20 dB accounted for 48.8% of cases. No case of facial paralysis, dizziness, formation of invaginations of the tympanic membrane and cholesteatoma were seen in the patients included in this study during the follow-up visits.Whether there are inflammatory proliferative lesions in the mastoidor not, tympanoplasty without mastoidectomy is feasible for chronic active otitis media. Moreover, different infection statuses of the middle ear do not cause difference in the postoperative relapse rate and hearing improvement.
本研究旨在评估不同感染状态下中耳单纯鼓室成形术的效果。113例（113耳）慢性中耳炎（COM）患者接受了单纯鼓室成形术。术前通过CT扫描发现所有患者乳突和鼓窦均有炎性增生性病变，并进行了超过1年的随访。根据感染情况将患者分为感染耳组（72耳）和未感染耳组（41耳）。我们使用SPSS统计软件分析疗效。113例患者中，92耳术后1/2至1个月耳道干燥，术后3 - 6个月鼓室内负压逐渐消失。感染耳组的72耳中，69耳术后耳道干燥，4例术中见鼓室内大量脓性分泌物，术后均耳道干燥。3例复发，耳道干燥率为95.8%。3耳鼓膜干性穿孔，气骨导差≤20 dB的有效耳占病例的51.4%。未感染组的41耳中，40耳术后耳道干燥，1例复发，耳道干燥率为97.6%。2耳鼓膜干性穿孔。气骨导差≤20 dB的有效耳占病例的48.8%。本研究纳入的患者在随访期间未出现面瘫、头晕、鼓膜内陷形成及胆脂瘤病例。无论乳突有无炎性增生性病变，单纯鼓室成形术对慢性活动性中耳炎都是可行的。而且，中耳不同的感染状态不会导致术后复发率和听力改善的差异。
