Clinical observation of the efficacy of complete open radical mastoidectomy
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摘要: 目的 比较完壁式与开放式乳突根治鼓室成形术治疗中耳胆脂瘤与慢性化脓性中耳炎的疗效。方法 回顾性分析2015年6月—2019年6月于徐州医科大学附属医院治疗的中耳胆脂瘤和慢性化脓性中耳炎患者的临床资料。根据手术方式不同，将患者分为2组：完壁组施行完壁式乳突改良根治术+鼓室成形术，开放组施行开放式乳突改良根治术+鼓室成形术。比较2组患者术后干耳时间、术后并发症发生率和复发情况、手术前后的气骨导差（ABG）。结果 开放组平均干耳时间为（38.9±8.5）d，完壁组平均干耳时间为（19.8±5.2）d，2组比较差异有统计学意义（P＜0.05）。开放组中术后并发症有24例（35%)。完壁组术后并发症有3例（13%）。完壁组的复发率为21%，高于开放组的复发率（4%），差异有统计学意义（P＜0.05）。术前2组患者ABG比较差异无统计学意义（P>0.05）；术后2组间ABG比较，完壁组（14.78±4.05）dB优于开放组（19.55±5.54）dB，差异有统计学意义（P＜0.05）。结论 与开放式相比，完壁式乳突根治鼓室成形术术后听力较好，并发症少，干耳时间短，但是复发率较高。Abstract: Objective To compare the efficacy of complete and open radical mastoidectomy combined with tympanoplasty for treatment of middle ear cholesteatoma and chronic suppurative otitis media. Methods Retrospective analysis was performed using clinical data from patients with middle ear cholesteatoma and chronic suppurative otitis media who were admitted into the Affiliated Hospital of Xuzhou Medical University from June 2015 to June 2019. According to their corresponding surgical methods, the patients were divided into two groups: a complete group which received complete modified radical mastoidectomy combined with tympanoplasty and an open group which received open mastoidectomy combined with tympanoplasty. The two groups were compared for postoperative dry ear time, complication and relapse incidences after surgery, and air bone gap (ABG) before and after surgery. Results The average time of dry ears was (38.9±8.5) d for the open group, and was (19.8±5.2) d for the complete group, which was statistically different (P<0.05). There were 24 cases (35%) of complications in the open group and 3 cases (13%) of complications in the complete group. The incidence of relapse was 21% for the complete group, which was remarkably higher than 4% for the open group (P<0.05). There was no statistical difference in ABG between the two groups before surgery (P>0.05). After surgery, the complete group presented remarkably better ABG (14.78±4.05) dB than the open group (19.55±5.54) dB (P<0.05). Conclusions Compared with open mastoidectomy, complete radical mastoidectomy combined with tympanoplasty presents better hearing, few complications and short dry ear time, despite of a high incidence of relapse.
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Keywords:
- complete radical mastoidectomy /
- open mastoidectomy
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