Veldman J E, Braunius W W
Academisch Ziekenhuis, afd. Keel-, Neus- en Oorheelkunde, Utrecht.
Ned Tijdschr Geneeskd. 1997 Aug 9;141(32):1563-7.
To describe the long-term results of revision surgery in patients with chronic otitis media.
University Hospital, Utrecht, the Netherlands.
A personal series of 323 revision mastoidectomies and (or) revision tympanoplasties was evaluated. Surgery was performed between 1981-1995 with a follow-up of one (minimal) to 14 years (maximal). Anatomical and functional results of various subgroups were compared.
A preoperative incidence of cholesteatoma of 34% (n = 99) dropped after revision surgery to 11% residual/recurrent cholesteatomas (n = 9). A dry, safe and disease-free ear with a closed tympanic membrane was obtained in nearly 90% of the cases. However, in 5% (n = 10) without pre-existent cholesteatoma (n = 199), a cholesteatoma developed de novo after revision surgery. A residual air-bone hearing gap < or = 30 dB resulted in 79% of the patients after revision tympanoplasty only (n = 27). Revision mastoidectomy with revision tympanoplasty in open (n = 91) and closed (n = 92) procedures lead to a residual air-bone gap < or = 30 dB in 56% of the open cases (n = 91) and in 73% of the closed cases (before the operation the figures were 37% and 55% respectively).
Revision mastoid surgery and (or) revision tympanoplasty can be quite rewarding and successful.
描述慢性中耳炎患者翻修手术的长期效果。
荷兰乌得勒支大学医院。
对个人的323例翻修乳突根治术和（或）翻修鼓室成形术病例进行评估。手术于1981年至1995年间进行，随访时间为1年（最短）至14年（最长）。比较了各个亚组的解剖学和功能结果。
术前胆脂瘤发生率为34%（n = 99），翻修手术后残留/复发性胆脂瘤降至11%（n = 9）。近90%的病例获得了鼓膜闭合、干燥、安全且无疾病的耳朵。然而，在无术前胆脂瘤的患者中（n = 199），有5%（n = 10）在翻修手术后新发胆脂瘤。仅行翻修鼓室成形术的患者中，79%（n = 27）术后气骨导差≤30 dB。开放式（n = 91）和封闭式（n = 92）翻修乳突根治术联合翻修鼓室成形术，开放式手术56%（n = 91）、封闭式手术73%的患者术后气骨导差≤30 dB（术前分别为37%和55%）。
翻修乳突手术和（或）翻修鼓室成形术可能收获颇丰且取得成功。
