ABSTRACT
Objective To reduce the recurrence rate and improving the hearing recovery effect in chronic otitis media patients with obstructive lesions in the attic, through the low bone intact-bridge tympanomastoidectomy.Methods A total of 23 patients with little severe or severe localized attic lesions granulation wrapped in ossicular chain blocking the entrance of tympanic antrum or affecting the attic drainage were included in this study.We have modified the intact-bridge tympanomastoidectomy to low bone intact-bridge tympanomastoidectomy (At the tympanic antrum entrance and lateral attic wall, we retained a more narrow low bone bridgestructure), completely cleared the localized lesions, released the activities limited ossicular chain and unobstructed the attic and middle tympanum drainage channel.And patients were followed up for 0.5~3 years.Results Before operations, the average pure tone auditory hearing threshold of all 23 patients was 43.91±9.90 dB HL,the preoperative air-bone gap was 24.04±5.10 dB.While the postoperative stable pure tone hearing test results were 33.17±7.63 dB HL and 14.70±4.52 dB, respectively.All patients had postoperative dry ear within 3 months.There was no recurrence of tympanic membrane perforation during follow-up.One patient had tympanic effusion(secretory otitis media) had accepted grommet insertion, 6 months after T-tube insertion, the tube was removed, and was followed up to 1 year.Conclusion The low bone intact-bridge tympanomastoidectomy by preservation of low bone bridge used in patients with chronic otitis media and obstructive lesions in the attic middle tympanum could reduce the recurrence rate and improve the recovery of hearing.
ABSTRACT
Objective To discuss with micro-tympanoplastic operation with osteo retention on treating cholesteatomatous otitismedis. Methods Choose 33 cases cholesteatomatous otitis medis patients who toke the tympanoplastic with osteo retention operation,then analyze the postulate and method of the operation, curative effect and complication after operation. Results Follow up with those patients by 12-72 months, and when 3-4 months after operation we endoscopiced the ears, could see that 43 cases of patients ear mastoid process and tympanic sinus were covered with epithelium, those mastoid cavity were well epithelial metaplasia;and the middle ear was separate from mastoid cavity; 39 cases patient of transplant eardrums are heal up (39/43, 90.7%). 2 cases have perforation of the tympanic membrane toke place after 4 months and 6 months with the operation, and it will heal up by anti-inflammatory drug and laser burning, 1 case had tympanic sinus hyperplasia with granulation tissue, and also had grassery juice; after taken anti-inflammatory drug and change bandage for 15 weeks, the symptom disappear. 1 case had grassery juice of operation cavity, after taking anti-inflammatory drug and physiotherapy, the symptom disappear in 24 weeks. After operation the pure tone audiometry shows that air conduction raise (16.8±6.8) dB HL, hearing raise up to:79.1%(34/43). Conclusion Base on right indication of operation choose, taken combined therapy of ambi-operation period, focus of infection are thoroughly cleaning up. Tympanoplastic with osteo retention are treating well with patients of cholesteatomatous otitismedis.