Meena Sunita, Kumar Rajesh, Meena Rakesh Kumar
Department of Otorhinolaryngology and Head and Neck Surgery, Pacific Institute of Medical Sciences, Udaipur, Rajasthan 313015 India.
Department of Otorhinolaryngology and Head and Neck Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh 221005 India.
Indian J Otolaryngol Head Neck Surg. 2024 Apr;76(2):1586-1594. doi: 10.1007/s12070-023-04364-2. Epub 2023 Dec 16.
To study the surgical result and efficacy of different methods of mastoid obliteration with cavity care. This prospective study included 60 patients who had cholesteatoma, conducted in the Department of Ear Nose and Throat (ENT), Institute of Medical Sciences, Banaras Hindu University, Varanasi from July 2015 to July 2017. The mastoid cavity was obliterated with either muscle flap/bone dust/hydroxyapatite. detailed history otoscopic examination was done pre-operatively and follow up were recorded at 1 month and 3 months in postoperative period. 60 patients were included, who underwent canal wall down mastoid surgery. each group muscle flap (group 1), bone dust (group 2) and hydroxyapatite (group 3) included 20 patients, age group 31-40 year with its maximum incidence of 43.3%, Preop PTA value were almost equal in all group but on comparison at 1 month in postoperative period significant improvement was present in group 1 versus 2(0.021) and group 2 versus 3(0.003) but not in group 1 versus 3. Although at 3 month there were significant improvement was present in all groups. The incidence of pain, discharge, giddiness and wax formation were markedly reduced and healing of cavities was early and better in obliterated cavities done by muscle flap and bone dust material as compared to hydroxyapatite cavities, at the end of 3 months. outcome and quality of life was better and almost equal in muscle flap and bone dust material group as compared to hydroxyapatite group.
研究不同乳突腔填充方法及腔隙护理的手术效果和疗效。这项前瞻性研究纳入了60例患有胆脂瘤的患者,于2015年7月至2017年7月在瓦拉纳西巴纳拉斯印度大学医学科学研究所耳鼻喉科进行。采用肌瓣/骨粉/羟基磷灰石对乳突腔进行填充。术前进行详细的病史采集和耳镜检查,并在术后1个月和3个月记录随访情况。纳入60例行开放式乳突手术的患者。每组肌瓣组(第1组)、骨粉组(第2组)和羟基磷灰石组(第3组)各20例,年龄31 - 40岁,发病率最高为43.3%,术前所有组的纯音听阈几乎相等,但术后1个月比较时,第1组与第2组(P = 0.021)以及第2组与第3组(P = 0.003)有显著改善,而第1组与第3组无显著改善。尽管在术后3个月所有组均有显著改善。与羟基磷灰石填充的腔隙相比,在3个月末,采用肌瓣和骨粉材料填充的腔隙中,疼痛、分泌物、头晕和耵聍形成的发生率明显降低,腔隙愈合更早且更好。与羟基磷灰石组相比,肌瓣和骨粉材料组的手术效果和生活质量更好且几乎相当。