Chen Jun, Zhang Yukai, Wen Liting, Han Yu, Liu Zhenzhen, Chen Yang, Qiu Jianhua, Zha Dingjun
Department of Otorhinolaryngology Head and Neck Surgery，Xijing Hospital，Air Force Medical University，Xi'an，710032，China.
Department of Ophthalmology and Otorhinlaryngology，Hospital of the 83rd Group Army of the People's Liberation Army.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Oct;34(10):888-891. doi: 10.13201/j.issn.2096-7993.2020.10.006.
To evaluate surgical effects on middle ear cholesterol granuloma（CG）. The patients receiving surgery due to middle ear CG were retrospectively analyzed. The choice of operative methods was made according to medical history, endotoscope, pure-tone audiometry and temporal bone CT. Tympanostomy tube（TT） insertion was performed on 12 patients; canal wall up（CWU） tympanoplasty combined with tympanostomy tube was performed on 40 patients, and canal wall down（CWD） tympanoplasty combined with TT on 14 cases. The pre-and postoperative audiometric results（500, 1000, 2000 and 4000 Hz） were evaluated for each patient. Then the average air-bone gap（ABG） was analyzed. One patient had postoperative tube obstruction. One patient who performed only TT insertion recurred. Secretory otitis media occurred in one case undergoing CWU tympanoplasty after removal of the ventilation tube. For TT insertion group, pre-and postoperative ABG levels were （21.25±5.96） dB and （8.85±6.49） dB, respectively（<0.01）. For CWU+TT group, pre-and postoperative ABG levels were （34.19±10.43） dB and （23.55±12.48） dB, respectively（<0.01）. For CWD+TT group, pre-and postoperative ABG levels were （36.43±12.11） dB and （25.71±13.50） dB, respectively（<0.01）. The aim of surgical treatment for middle ear CG includes thorough removal of lesions, improvement of ventilation and drainage of middle ear. Individualized surgical strategy should be adopted according to the patients' conditions. And long-term follow-up should be done after operation.
评估手术治疗中耳胆固醇肉芽肿（CG）的效果。对因中耳CG接受手术的患者进行回顾性分析。根据病史、耳内镜、纯音听力测定和颞骨CT结果选择手术方式。12例患者行鼓膜置管术（TT）；40例患者行上鼓室开放（CWU）鼓室成形术联合鼓膜置管术；14例患者行下鼓室开放（CWD）鼓室成形术联合TT。评估每位患者术前和术后的听力测定结果（500、1000、2000和4000赫兹）。然后分析平均气骨导间距（ABG）。1例患者术后出现导管阻塞。1例仅行TT置入术的患者复发。1例接受CWU鼓室成形术的患者在取出通气管后发生分泌性中耳炎。对于TT置入组，术前和术后ABG水平分别为（21.25±5.96）分贝和（8.85±6.49）分贝（<0.01）。对于CWU+TT组，术前和术后ABG水平分别为（34.19±10.43）分贝和（23.55±12.48）分贝（<0.01）。对于CWD+TT组，术前和术后ABG水平分别为（36.43±12.11）分贝和（25.71±13.50）分贝（<0.01）。中耳CG手术治疗的目的包括彻底清除病变、改善中耳通气和引流。应根据患者情况采取个体化手术策略。术后应进行长期随访。
