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胆脂瘤手术后的生活质量:手术技术比较。

Quality of life after cholesteatoma surgery: comparison between surgical techniques.

机构信息

Otolaryngology Unit, Department of BMS, Neuroscience and Sensory Organs, University of Bari, Bari, Italy.

Biomedical Sciences and Human Oncology Department, University of Bari, Bari, Italy.

出版信息

Acta Otorhinolaryngol Ital. 2022 Jun;42(3):293-299. doi: 10.14639/0392-100X-N1998.

Abstract

OBJECTIVE

To evaluate the long-term quality of life (QoL) in patients operated for cholesteatoma by canal wall-up tympanoplasty (CWUT) or canal wall-down tympanoplasty (CWDT) with mastoid obliteration.

METHODS

QoL was evaluated by the Chronic Otitis Media Questionnaire - 12 (COMQ-12). For each patient, the total score and three partial subscores, concerning disease activity, functional impairment and general impact on the patient's life were calculated. These scores were correlated with the surgical technique, as well as anatomical and functional results.

RESULTS

68 procedures were classified as CWUT and 78 as CWDT with obliteration. The mean follow-up was 65 months. Total and partial COMQ-12 scores did not show any significant difference between the two groups. Correlation analysis showed a significant direct association between the postoperative Air-Bone Gap (ABG) and both the COMQ-12 total score and functional subscore in the CWUT group.

CONCLUSIONS

This is the first study comparing CWUT and CWDT with obliteration with the COMQ-12, thus confirming the overlapping results in terms of QoL. These findings, together with the evidence of the significantly lower rates of recidivism, show that CWDT with obliteration should be considered as a good alternative to CWUT.

摘要

目的

评估完壁式鼓室成形术(CWUT)或完壁式鼓室成形术联合乳突腔填塞术(CWDT)治疗胆脂瘤患者的长期生活质量(QoL)。

方法

采用慢性中耳炎问卷-12 (COMQ-12)评估 QoL。为每位患者计算总评分和三个部分子评分,分别涉及疾病活动度、功能障碍和对患者生活的总体影响。这些评分与手术技术以及解剖和功能结果相关联。

结果

68 例被分类为 CWUT,78 例为 CWDT 并进行乳突腔填塞。平均随访时间为 65 个月。CWUT 组和 CWDT 组的 COMQ-12 总分和部分子评分之间没有显著差异。相关性分析显示,术后气骨导差(ABG)与 CWUT 组的 COMQ-12 总分和功能子评分呈显著正相关。

结论

这是第一项使用 COMQ-12 比较 CWUT 和 CWDT 联合乳突腔填塞的研究,从而在 QoL 方面确认了重叠的结果。这些发现,加上复发率显著降低的证据,表明 CWDT 联合乳突腔填塞术应被视为 CWUT 的良好替代方案。

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