Coker N J, Jenkins H A, Fisch U
Ann Otol Rhinol Laryngol. 1986 Jan-Feb;95(1 Pt 1):5-11. doi: 10.1177/000348948609500102.
Lateral surgical approaches to the base of the skull through the temporal bone often result in a large cavity with exposed dura and vascular structures and no possibility of reconstruction of the middle ear conductive hearing mechanism. Subtotal petrosectomy with tympanomastoid obliteration provides a relatively safe and secure closure of the surgical defect in the temporal bone and eliminates the problems associated with an open mastoid cavity. Eradication of all accessible air cell tracts and mucosa in the petrous pyramid, obliteration of the eustachian tubal orifice, closure of the external auditory canal, and fat obliteration of the middle ear and mastoid clefts are essential in the procedure. Over the last 10 years this technique has been utilized in 372 base of skull procedures with a complication rate of less than 5%. Infection occurred only in those cases with draining cavities or contaminated wounds.
经颞骨向颅底的外侧手术入路常常会导致形成一个大腔隙，硬脑膜和血管结构暴露在外，且中耳传导性听力机制无法重建。颞骨次全切除术联合鼓室乳突腔填塞术能相对安全可靠地封闭颞骨手术缺损，并消除与开放乳突腔相关的问题。在该手术中，彻底清除岩尖内所有可及的气房通道和黏膜、封闭咽鼓管开口、封闭外耳道以及用脂肪填塞中耳和乳突裂隙至关重要。在过去1０年里，这项技术已应用于372例颅底手术，并发症发生率低于5%。感染仅发生在那些有引流腔隙或伤口受污染的病例中。
