中耳弥漫性炎性感染伴胆脂瘤行岩骨次全切除术的经验分析

doi:10.3969/j.issn.1009-976X.2020.04.025

摘要/Abstract

摘要： 目的介绍中耳弥漫性炎性感染伴胆脂瘤行岩骨次全切除术中用带蒂颞肌瓣充填中耳乳突腔但不封闭外耳道的方法及观察术后效果。方法对6例成人单侧中耳弥漫性炎性感染伴胆脂瘤患者行岩骨次全切除术,行耳甲腔成形,用带蒂颞肌瓣充填中耳乳突腔,同时封闭咽鼓管,但未封闭外耳道,观察术后并发症,干耳时间。结果术后随访1年以上,所有6例患者术后均无脑脊液耳漏,无脑膜炎等颅内感染,4例患者术后3个月干耳,2例患者术后6个月干耳,其中1例患者在术后1年出现胆脂瘤局部复发,但无耳流脓,予定期耳内镜下清理。结论岩骨次全切除术是治疗中耳弥漫性炎性感染伴胆脂瘤的有效方法,用带蒂颞肌瓣充填中耳乳突腔,封闭咽鼓管,可有效地防止相关并发症发生及中耳乳突再发感染,不封闭外耳道口有利于术后随访清理。

关键词: 弥漫性, 中耳胆脂瘤, 炎性感染, 岩骨次全切除术

Abstract: Objective To introduce the method of filling the mastoid cavity of middle ear with pedicled temporalis muscle flap without sealing the external auditory canal and observe the postoperative effect. Methods Six cases of adult patients with cholesteatoma with unilateral diffuse inflammatory infection of the middle ear were performed Subtotal Petrosectomy, ear cavity forming, filling with pedicle temporalis flap middle ear mastoid cavity, eustachian tube closed at the same time, but not sealing the external auditory canal, observe the postoperative complications, the dry ear time. Results All 6 patients had no cerebrospinal fluid leakage or intracranial infection, 4 patients had dry ears 3 months after the operation, 2 patients had dry ears 6 months after the operation, 1 patient had local recurrence of cholesteatoma 1 year after the operation, but no ear pus, and was cleaned regularly under ear endoscopy. Conclusion Subtotal Petrosectomy is an effective method for the treatment of diffuse inflammatory infection with cholesteatoma in the middle ear. Filling the mastoid cavity of middle ear with pedicled temporalis muscle flap, sealing the eustachian tube can effectively prevent the occurrence of related complications and secondary infection of middle ear mastoid process, and unsealing the external auditory canal is good for postoperative follow-up.

Key words: inflammatory infection, middle ear cholesteatoma, diffuse, subtotal petrosectomy

中图分类号:

R651

邹团明, 陈俊明, 刘振, 孙恺, 王博琛, 陈抗松, 虞幼军. 中耳弥漫性炎性感染伴胆脂瘤行岩骨次全切除术的经验分析[J]. 岭南现代临床外科, 2020, 20(04): 517-521.

ZOU Tuan-ming, CHEN Jun-ming, LIU Zhen, SUN Kai, WANG Bo-chen, CHEN Kang-song, YU You-jun. Subtotal petrosectomy for middle ear diffuse inflammatory infection with cholesteatoma： our experiences[J]. Lingnan Modern Clinics in Surgery, 2020, 20(04): 517-521.

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