上鼓室重建对慢性中耳炎开放式鼓室成形术作用的临床研究

目的：观察在开放式鼓室成形术中，重建上鼓室对慢性中耳炎治疗的临床疗效。方法：86例（86耳）慢性中耳炎患者随机均分两组：两组均行开放式鼓室成形术，其中实验组应用自体乳突骨粉联合耳后肌骨膜瓣缩窄乳突根治腔，并垫高上鼓室内壁；对照组不行乳突根治腔缩窄术。回顾性观察两组患者在鼓膜状态（内陷及穿孔）、干耳时间、听力提高，头晕头痛、肉芽增生等几个方面的恢复情况。结果：通过对两组病例进行随访和疗效分析，在鼓膜状态、干耳时间、头晕头痛等方面，其临床疗效差异有显著性（P〈0．05）；而在术后听力提高及肉芽增生方面无显著性差异（P〉0．05）。结论：在慢性中耳炎开放式鼓室成形术中，自体材料的应用缩短了千耳时间、提高了手术疗效，减少了手术相关的并发症。

Clinical Research of the Role of attic Reconstruction in the Open Radical Mastoidectomy and Tympanoplasty for Chronic Otitis Media

Objective： To investigate the clinic efficacy of attic reconstruction in the open radical mastoideetomy and tympanoplasty for chronic otitis media. Methods： Eighty-six cases with chronic otitis media were divided randomly into two groups, and open mastoidectomy with tympanoplasty were operated on the all patients. The mastoid cavity of experimental group were decreased and the lateral walls were rebuilt with autogenous mastoid bone chips and museul-osseous flap after open tympanoplasty; no coarctation was implemented in control group. Postoperative recovery of all patients were observed through retrospective means in two groups. Tympanle membrane state （retraction and perforation）, dry ear, hearing improved, dizziness, headache and granulation of the recovery about patients in two groups were retrospectively observed. Results： There are significant difference between two groups in recurrence, dry ear time, headache and dizziness according to follow-up and analysis of clinic efficacy（P〈0.05）; No difference in perforation of ear drum and hearing raise （P〉0.05）. Conclusion： In open tympanoplasty for chronic otitis media, dry ear time can be shorten and correlative complication can be decreased by reconstruction of the posterior external auditory canal wall with autogenous mastoid bone chips and auricular cartilage.