- 期刊
慢性中耳炎唯－聽耳或良聽耳之手術
Surgery of the Only Hearing or Better Hearing Ear with Chronic Otitis Media
摘要
唯一聽耳與良聽耳慢性中耳炎的處理，是個見仁見智的問題。手術可能造成病人進一步的聽力損失，而未處理的化膿耳或膽魯瘤也會持續使聽力惡化，兩者均導致殘障。自1986至1995之10年間，我們經歷了33而唯一聽耳或良聽耳的慢性中耳炎手術，占同一期間所有慢性中耳炎手往1612耳的2.1%。唯一聽耳有24耳，其中7耳合併有膽脂瘤。手往方法為鼓室成形術第1型13例，第2型3例，第3型4例，第4型2例，修正乳突根治術2例，第3型3例，第4型1例，修正乳突根治術1例。手術後平均追蹤4年11個月，30耳鼓膜完整，未再發流膿，膽脂瘤也未發。聽力結果33耳中有17耳改善，平均聽力閾值進步13Db，質骨導差值平均減少12Db。慢性中耳炎唯一聽耳與良聽耳的手術應選擇有膽脂瘤，無控制的耳漏或有感覺視聽障的病耳。術前應與病人解釋並確定其了解，術中應盡量避免傷害內耳機能，除去發炎病灶與膽脂瘤後應即重建聽力，避免再次手往，並且由熟練的耳鼻喉科醫師執行。(中耳醫誌 1997;32:272-276)
並列摘要
The management of chronic ear disease affecting the only hearing or better hearing ear is a controversial subject. From 1986 to 1995, among 1612 cases of chronic otits media,33 (2.1%) only hearing or better hearing ears were operated by senior author. Cholesteatoma was found in 9 of these cases. In the 24 only-hearing ears, tympanoplasty type 1 (13 ears), type 2(3 ears), type 3(4 ears), tye 4(2 ears) and classic modified radical mastoidectomy (2ears) were performed. In the 9 betterhearing ears, tympanoplasty tye 1(4 ears), type 3(3 ears), type 4(1 ears) and classic modified radical mastoidectomy (1 ears) were performed. In an average period of 4 years and 11 months follow up, reperforation was found in only 3 cases, and in 23 cases hearing improvement was noted.
延伸閱讀
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