HRCT评价化脓性中耳炎患者微创手术术前听骨破坏及疗效分析

doi:10.7517/issn.1674-0475.220314

摘要/Abstract

摘要： 探讨手术前采用高分辨率CT （HRCT）评价慢性化脓性中耳炎患者听骨破坏的价值及微创手术治疗效果。选取128例慢性化脓性中耳炎患者作为研究对象，其中，68例患者采用微创手术治疗（微创组）、60例患者采用传统开放手术治疗（传统组）。所有患者术前均接受HRCT检查，分析术前HRCT诊断听骨破坏的程度与手术中所见的差异，并对比两组的治疗效果。结果显示，51例骨疡型慢性化脓性中耳炎患者，术前HRCT检查的锤骨头、锤骨柄部、砧骨体、砧骨长脚、砧骨短脚、豆状突、镫骨的病变损害程度与手术中所见进行比较，差异无统计学意义（P>0.05）；77例胆脂瘤型慢性化脓性中耳炎患者，术前HRCT检查的锤骨头、锤骨柄部、砧骨体、砧骨长脚、砧骨短脚、豆状突、镫骨的病变损害程度与手术中所见进行比较，差异无统计学意义（P>0.05）。术后再次复查，微创组患者的气导听力阈值显著低于传统组（P<0.05）；术后1个月进行临床疗效比较，微创组患者的手术效果优于传统组患者（P<0.05）。HRCT术前评价慢性化脓性中耳炎患者听骨破坏程度与手术中所见具有高度的一致性，同时，慢性化脓性中耳炎患者采用微创手术的效果更好。

关键词: 高分辨率CT, 慢性化脓性中耳炎, 听骨破坏, 微创手术

Abstract: This study investigated the value of high-resolution computed tomography (HRCT) in evaluating ossicular destruction for patients with chronic suppurative otitis media before surgery and the effect of minimally invasive surgery. 128 patients with suppurative chronic otitis media were selected as the research subjects. Among them, 68 patients were treated with minimally invasive surgery (the minimally invasive group), and 60 patients were treated with traditional open surgery (the traditional group). All patients underwent HRCT examination before operation, and analyzed the differences between the degree of ossicular destruction diagnosed by HRCT before operation and those seen during operation, and then compared the therapeutic effects of the two groups. The results showed that, the lesions of the malleus head, the shank of the malleus, the incus body, the incus long foot, the incus short foot, the lentiform process and the stapes in 51 patients with chronic suppurative otitis media of bone ulcer type were examined by preoperative HRCT, and compared with what was seen during operation, there was no significant difference between the two groups (P>0.05). Compared with surgical findings the preoperative HRCT examination of the head of malleus, shank of malleus, body of incus, long foot of incus, short foot of incus, lenticular process, stapes lesions and operation in 77 patients with cholesteatoma-type chronic suppurative otitis media, there was no statistically significant difference between the two groups (P>0.05). Re-examination after surgery, the air conduction hearing threshold of the patients in the minimally invasive group was significantly lower than that of the traditional group (P<0.05). Compared the clinical efficacy 1 month after the operation, the surgical effect of the minimally invasive group was better than that of the traditional group (P<0.05). HRCT preoperative evaluation of the degree of ossicular destruction in patients with chronic suppurative otitis media was highly consistent with surgical findings, and minimally invasive surgery was more effective in patients with chronic suppurative otitis media.

Key words: high-resolution CT, chronic suppurative otitis media, ossicular destruction, minimally invasive surgery

鲍清明, 谢小轶. HRCT评价化脓性中耳炎患者微创手术术前听骨破坏及疗效分析[J]. 影像科学与光化学, 2022, 40(4): 863-867.

BAO Qingming, XIE Xiaoyi. HRCT Evaluation of Ossicular Destruction in Patients with Suppurative Otitis Media before Minimally Invasive Surgery and its Efficacy Analysis[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(4): 863-867.

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