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Objective To compare the clinical efficacy of different surgical treatment on cholesteatoma otitis media and analy‐sis its differences .Methods Totally 100 cases of patients with cholesteatoma otitis media in hospital were divided into two groups , 50 cacse in each group ,the control group used open mastoidectomy for treatment ,the experimental group used complete bi‐style mastoidectomy ,and the postoperative clinical efficacy were observed .Results The experimental group patients after radical mas‐toidectomy complete bi‐style treatment ,air conduction hearing threshold (26 .89 ± 7 .23)dBHL and gas bone conduction (12 .54 ± 3 .78)dBHL were significantly lower than after open radical mastoidectomy treatment of patients in the control group (41 .38 ± 10 .56)dBHL and gas bone conduction (22 .57 ± 5 .96)dBHL(P<0 .05);after different surgical treatment ,the cholesteatoma otitis media total efficiency (92 .00% ) of experimental group was significantly higher than control group (64 .00% ) ( P< 0 .05 ) . Conclusion The complete bi‐style mastoidectomy is the treatment of cholesteatoma otitis media ,which can effectively repair dam‐aged eardrum ,restore patient hearing to the maximum extent ,help to restore patient′s disease and improve the quality of life of pa‐tients .
RESUMO
Objective To carry out a meta-analysis on the published data to evaluate therapeutic effects of intact canal wall mastoidectomy and open mastoidectomy for cholesteatoma otitis media .Methods A comprehensive search was performed in VIP (1989-2015) ,WANFANG (1999-2015) ,CNKI (1994-2015) and CAJD databases to collect the randomized controlled trials (RCTs) on the intact canal wall mastoidectomy and open mastoidectomy treat cholesteatoma otitis media ,and to analyze the RCTs in meta -analysis method .Results 1 069 patients were analyzed in the 18 RCTs which met the inclusion criteria .Patients were followed up from 3 months to 7 years .The meta-analysis results suggested that ,compared with the open mastoidectomy group ,the patients had less operative time (test for overall effect :Z=15 .54 ,MD= -18 .36 ,95% CI(-24 .54 ,-12 .18) , P10 dB (test for overall effect:Z=2 .83 ,OR=2 .47 ,95% CI(1 .32 , 4 .61) ,P=0 .005) ,more patients with air-bone gaps <20 dB(Z=3 .05 ,OR=1 .60 ,95% CI(1 .18 ,2 .17) ,P=0 .002) ,but the recurrent rate is not different significantly (test for overall effect :Z= 1 .92 ,OR =1 .87 ,95% CI (0 .99 ,3 .53) ,P=0 .05) .Conclusion The illness is suitable to be treated by using the two surgical ways while the intact canal wall mastoidectomy treatment takes less operative time ,dry ear time and complications ,and improve hearing more significantly than the open mastoidectomy ,but the recurrent rate is not different significantly for trea‐ting cholesteatoma otitis media .
RESUMO
Objective To investigate the clinical effects of the surgery of mastoid muscle periosteum valvuloplasty after modified radical mastoidectomy treatment of cholesteatoma otitis media.Methods 52 cases (52 ears)cholesteatoma otitis media patients for the observation group were collected.The patients in the observation group were treated by mastoid muscle periosteum valvuloplasty after modified radical mastoidectomy.49 cases (49 ears) for the control group were treated by concomitant mastoidectomy and the classic conchaplasty cavity angioplasty.Results Patients were followed up for 1 year.38 ears were dry in control group(77.6％),8 ears were recurrenced(16.3％),regular clean-up of surgical cavity at least 3 months postoperative.50 ears were dry in observation group (95.2％),dry ear rate was significantly higher (x2 =12.374,P =0.000) ;1 ears was recurrenced(2.4％),the recurrence rate was significantly reduced (x2 =11.966,P =0.000) ; Operative cavity after complete epithelialization no longer need to be cleaned regularly; No postoperative complications (such as periosteal flap or pinna cartilage of the mastoid muscle necrosis,facial paralysis,dizziness)were occurred,the prognosis was good.Conclusion The surgery of mastoid muscle periosteum valvuloplasty after modified radical mastoidectomy treatment of otitis media with cholesteatoma is safe and effective,which is worthy of promotion.