摘要
鼓室硬化症常可在中耳手術中看到，有學者認為此乃病理現象且和地3型免疫複合體疾病相關；亦有人認為是一種痊癒過程的終點，並非一種疾病。本科自1982年1月至1988年12月，手術中共經歷220例鼓室硬化症，男性77例，女性143例，年齡分佈由18歲至65歲不等，平均32歲。病人依不同病況，接受不同手術方式，術後聽力追蹤 3個月至8年不等，結果發現術後聽力未改善之主因為：①上鼓室聽小骨固著時，只施行上鼓室聽小骨鬆動術，因纖維結疤組織造成聽小骨固著；②上鼓室聽小骨固著時，取下砧骨轉位施行第3或第4型鼓室成形術，未同時切斷鼓膜張肌腱及切除鎚骨頭在固著；③镫骨固著時，只清除硬化塊並搖動镫骨，未完全清除周圍之纖維結締組織，易因結疤組織造成镫骨在固著。我們建議當鼓室硬化症引起上鼓室固著時，一取下砧骨，切斷鼓膜張肌腱，切除鎚骨頭，施行第3或地4行之鼓室成形術；當镫骨固著時，宜完全清除鼓室硬化塊及周圍纖維結締組織，必要時同時切斷镫骨肌鍵，才可避免日後發生聽小骨在固著。
並列摘要
The results of operations for tympanosclerosis in 220 patients are presented. Different procedures (ossicle mobilization, tympanoplasty I-IV , stapedo-tomy, etc.) were applied in patients with different middle ear conditionds. One hundred and eighty-two post opera cases were well followed by pure tone audiome- try renged from 3 months to 8 years. The factors accecting the prognosis of hearing were analysed. We recommen that l) complete removal of tympanosclerotic paque and connective tissue arouund the oval window with delicate mobilization of the stapes is safe and effective for tympanosclerosis with stapes fixation, 2) Type III or type IV tympanoplasty after removal of the incus, mallear head and severance of the tensor tympani muscle is preferable in preventing further refgixation for cases attic fixation.
延伸閱讀
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