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[胆脂瘤的功能性手术。I. 闭合技术]

[Functional surgery of cholesteatoma. I. Closed techniques].

作者信息

Lacosta J L, Infante J C, Pisón F

机构信息

Servicio de ORL, Hospital San Millán, Logroño.

出版信息

Acta Otorrinolaringol Esp. 1997 Mar;48(2):115-20.

PMID:9198461
Abstract

A review was made of 138 ears treated with walled-up canal tympanoplasty for chronic otitis media with cholesteatoma. In 66.7% of the ears, two-stage operations were performed. Cholesteatomas were located in the attic (72.5%), mesotympanum (42.8%), antrum (39.1%), and mastoid (11.6%). The most common lesion of the ossicular chain was incus necrosis (61.6%). Total ossicular replacement prosthesis (TORP) (56.5%), partial ossicular replacement prosthesis (PORP) (21.7%), mastoid cortical bone autograft (13%), and incus autograft (8.7%) were used to reconstruct the ossicular chain. After three years, 56.5% of the operated cars were free of complications. The rest had the following complications: recurrence of cholesteatoma (17.4%), perforation of the neotympanum (12.5%), prosthesis extrusion (9.4%), and episodes of otorrhea (4.2%). The best functional results were obtained with autografts (cortical and incus) and TORP.

摘要

对138例采用外耳道壁上鼓室成形术治疗胆脂瘤型中耳炎的耳朵进行了回顾性研究。66.7%的耳朵接受了两期手术。胆脂瘤位于上鼓室(72.5%)、中耳(42.8%)、鼓窦(39.1%)和乳突(11.6%)。听骨链最常见的病变是砧骨坏死(61.6%)。采用全听骨置换赝复物(TORP)(56.5%)、部分听骨置换赝复物(PORP)(21.7%)、乳突皮质骨自体移植(13%)和砧骨自体移植(8.7%)来重建听骨链。三年后,56.5%的手术耳无并发症。其余的出现了以下并发症:胆脂瘤复发(17.4%)、新鼓膜穿孔(12.5%)、赝复物脱出(9.4%)和耳漏发作(4.2%)。自体移植(皮质骨和砧骨)和TORP获得了最佳的功能结果。

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