Departments of Otorhinolaryngology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of Otorhinolaryngology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan.
Eur Arch Otorhinolaryngol. 2023 Mar;280(3):1111-1117. doi: 10.1007/s00405-022-07579-1. Epub 2022 Aug 4.
To analyze the prevalence and associations of facial canal dehiscence (FCD), dural exposure, and labyrinthine fistula in chronic otitis media (COM) with and without cholesteatoma.
This was a retrospective study performed in an academic medical center. Patients who received tympanoplasty with mastoidectomy for COM with and without cholesteatoma were included. The prevalence of FCD, dural exposure, and labyrinthine fistula in COM with and without cholesteatoma (mastoiditis) and their relationships were analyzed.
A total of 189 patients, including 107 (56.6%) females and 82 (43.4%) males, with 191 ears were included. There were 149 cases (78.0%) of cholesteatoma and 42 patients (22.0%) with mastoiditis. FCD was noted in 27.5% of patients with cholesteatoma and 9.5% of patients with mastoiditis. Dural exposure was found in 21 patients (14.1%) with cholesteatoma and 4 patients (9.5%) with mastoiditis. Eleven patients (7.4%) with cholesteatoma and 1 patient (2.4%) with mastoiditis had labyrinthine fistula. Patients with a labyrinthine fistula had nearly a fivefold greater chance (OR = 4.924, 95% CI = 1.355-17.896, p = 0.015) of having FCD than those without a fistula. There was a positive correlation between dural exposure and labyrinthine fistula (P = 0.011, Fisher's exact test).
FCD, dural exposure, and labyrinthine fistula are common complications in COM. These complications are more frequently observed in patients with cholesteatoma than in patients with mastoiditis. Surgeons should pay more attention to the treatment of COM.
分析慢性中耳炎（COM）伴或不伴胆脂瘤患者的面神经管缺损（FCD）、硬脑膜暴露和迷路瘘管的发生率及其相关性。
这是一项在学术医疗中心进行的回顾性研究。纳入接受乳突切开并鼓室成形术治疗 COM 伴或不伴胆脂瘤的患者。分析 COM 伴或不伴胆脂瘤（乳突炎）患者 FCD、硬脑膜暴露和迷路瘘管的发生率及其关系。
共纳入 189 例患者，其中 107 例（56.6%）为女性，82 例（43.4%）为男性，共 191 耳。149 例（78.0%）为胆脂瘤，42 例（22.0%）为乳突炎。胆脂瘤患者中 FCD 的发生率为 27.5%，乳突炎患者为 9.5%。胆脂瘤患者中硬脑膜暴露的发生率为 21 例（14.1%），乳突炎患者为 4 例（9.5%）。11 例（7.4%）胆脂瘤患者和 1 例（2.4%）乳突炎患者存在迷路瘘管。存在迷路瘘管的患者发生 FCD 的可能性是无瘘管患者的近五倍（OR=4.924，95%CI=1.355-17.896，p=0.015）。硬脑膜暴露与迷路瘘管之间存在正相关（P=0.011，Fisher 确切检验）。
FCD、硬脑膜暴露和迷路瘘管是 COM 的常见并发症。这些并发症在胆脂瘤患者中比在乳突炎患者中更为常见。外科医生应更加重视 COM 的治疗。
