广州医药 ›› 2019, Vol. 50 ›› Issue (3): 52-55.DOI: 10.3969/j.issn.1000-8535.2019.03.014

• 论著 • 上一篇    下一篇

耳内窥镜在中耳胆脂瘤患者手术中的价值分析

艾力, 张奕, 吴小海, 杨应浩, 黄旭龙, 冯桂明   

  1. 广州新海医院耳鼻喉科 (广州510300)
  • 收稿日期:2019-01-23 出版日期:2019-05-20 发布日期:2021-12-17

The value of otoendoscopy in the operation of middle ear cholesteatoma

AI Li, ZHANG Yi, WU Xiaohai, YANG Yinghao, HUANG Xulong, FENG Guiming   

  1. Department of ENT, Guangzhou Xinhai Hospital, Guangzhou 510300, China
  • Received:2019-01-23 Online:2019-05-20 Published:2021-12-17

摘要: 目的 分析在中耳胆脂瘤患者中耳内窥镜的价值。方法 回顾性分析61例单侧中耳胆脂瘤患者的临床资料,均接受手术治疗,其中有31例实施耳内窥镜下手术,记为A组;有30例实施常规鼓室成形术,记为B组。对比2组术前和术后1个月气骨导差和气道听阈变化,临床效果和术后并发症。结果 术后1个月A组气骨导差和气道听阈分别为(8.5±1.5)dB、(21.2±2.4)dB,均较术前下降(t=38.195,P<0.001;t=27.739,P<0.001),B组分别为(13.4±2.3)dB、(25.6±2.7)dB,均较术前下降(t=23.510,P<0.001;t=21.575,P<0.001),且术后1个月A组气骨导差和气道听阈均低于B组(t=9.888,P<0.001;t=6.732,P<0.001);A组与B组临床效果分布对比差异有统计学意义(Z=6.102,P=0.014),且A组总有效率为100.00%,高于B组的83.33%(χ2=5.628,P=0.018);A组总并发症发生率为3.23%,低于B组的20.00%(χ2=4.223,P=0.040)。结论 在中耳胆脂瘤患者手术中应用耳内窥镜治疗能够显著改善气骨导差和气道听阈,较常规鼓室成形术效果更佳,安全性更高。

关键词: 耳内窥镜, 中耳胆脂瘤, 鼓室成形术, 气骨导差, 气道听阈

Abstract: Objective To analyze the value of middle ear endoscopy in patients with middle ear cholesteatoma. Methods The clinical data of 61 patients with unilateral middle ear cholesteatoma were retrospectively analyzed. All of them underwent surgery. Among them, 31 underwent otoendoscopic surgery, which was recorded as group A; 30 underwent conventional tympanoplasty, which was recorded as group B. The changes of air-bone conduction, airway auditory threshold, clinical effect and complications were compared between the two groups before and 1 month after operation. Results One month after operation, the difference of air-bone conduction and airway auditory threshold in group A were (8.5±1.5) dB and (21.2 ±2.4) dB, were lower than those before operation (t=38.195, P<0.001;t= 27.739,P<0.001), group B were (13.4±2.3) dB and (25.6±2.7) dB, respectively, lower than those before operation (t= 23.510,P<0.001;t=21.575,P<0.001), one month later, the air-bone conduction and airway hearing threshold in group A were lower than those in group B (t=9.888,P=0.000;t=6.732,P<0.001); The difference was statistically significant in clinical effect distribution between group A and group B (Z=6.102,P= 0.014), and the total effective rate of group A was 100.00%, which was higher than that of group B 83.33% (χ2= 5.628,P=0.018); the total incidence of complications in group A was 3.23%, lower than that in group B 20.00% (χ2= 4.223,P=0.040). Conclusion Endoscopic ear surgery may improve the air-bone conduction and airway auditory threshold in patients with middle ear cholesteatoma, which is more effective and safe than conventional tympanoplasty.

Key words: Otolaroscopy, Middle ear cholesteatoma, Tympanoplasty, Air-bone conduction, Airway auditory threshold