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Cholesteatoma otitis media and supratubal recess
Author(s): 
Pages: 491-493
Year: Issue:  7
Journal: CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY

Keyword:  胆脂瘤中耳咽鼓管解剖学局部;
Abstract: 目的 探讨咽鼓管上隐窝及其与上鼓室空气通道的状态在胆脂瘤中耳炎发病过程中的意义.方法 观察胆脂瘤中耳炎52例(52耳,观察组)及乳突气化良好无慢性中耳炎病史的外伤性面神经麻痹患者16例(16耳,对照组)术中咽鼓管上隐窝及其与上鼓室通道开放状态.结果 对照组16耳均呈清晰的咽鼓管上隐窝结构,呈膜性闭锁4耳(25.0%).观察组52耳(100%)咽鼓管上隐窝与上鼓室前方呈完全闭锁,无相通病例.与对照组差异有统计学意义(χ2=46.421,P=0.000).其中骨性闭锁34耳(65.4%),膜性闭锁18耳(34.6%);上鼓室空间狭小.全组均为硬化或气化不良型乳突.结论 咽鼓管上隐窝与上鼓室的气流通道闭塞更容易造成上鼓室和乳突负压状态,可能是形成胆脂瘤的原因之一;咽鼓管上隐窝与上鼓室通道的解剖学变异可能是胆脂瘤中耳炎的易患因素.提示胆脂瘤中耳炎行完壁式鼓室成形术时开放该通道可能有助于防止术后复发.
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