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并发于胆脂瘤型中耳炎的迷路瘘管临床特征分析

ISSN号：1001-1781
期刊名称：《临床耳鼻咽喉头颈外科杂志》
时间：0
分类：R764.21[医药卫生—耳鼻咽喉科;医药卫生—临床医学]
作者机构：[1]解放军总医院耳鼻咽喉头颈外科,北京100853
相关基金：国家重大科学研究计划干细胞项目（No：2012CB967900）; 国家973计划重大科学问题导向项目（No：2011CBA01000）; 863青年科学家项目（No：2014AA020510）; 国家科技部新药创制重大专项（No：2014ZX09J14101-06C）; 国家自然科学基金项目（No：NSFC 81470700）

作者：王方园[1], 吴南[1], 侯昭晖[1], 刘军[1], 申卫东[1], 韩维举[1], 杨仕明[1]

关键词：迷路瘘管, 胆脂瘤型中耳炎, 临床特征, labyrinthine fistula choleseatoma otitis media, clinical features

中文摘要：

目的：探讨迷路瘘管的相关临床特征,了解不同类型瘘管术前诊断、术中处理以及预后情况。方法：回顾性分析我院2007-01-2014-11期间收治的42例（43耳）迷路瘘管病例,收集其术前临床表现、听力学检测结果、影像学数据、术中所见及处理方式和术后恢复情况,并进行统计学分析。结果：根据术中所见确诊的42例（43耳）患者中,有39例（40耳）的迷路瘘管发生在外半规管,1例发生在后半规管,1例在上半规管,1例同时伴有外半规管和后半规管瘘。术前24耳（55.8%）表现有眩晕症状,14耳（32.6%）出现了骨导听力受损。根据Dornhoffer分型标准,结合术中所见,确诊为Ⅰ型瘘管22例（23耳）,Ⅱ型瘘管9例,Ⅲ型瘘管11例。比较3组间术前听力损失分型、眩晕发生率、CT诊断阳性率、面神经骨管受损率、术后骨导听力变化率、术后眩晕发生率均差异无统计学意义（均P〉0.05）。结论：术前临床症状、听力及CT等客观检查并不能完全准确诊断迷路瘘管的发生,其确诊需要依靠术中所见,手术处理方式需依据病变情况个体化处理,不同类型迷路瘘管的预后无明显差异。

英文摘要：

Objective：To investigate the clinical features of labyrinthine fistula and obtain the diagnosis, treat- ment and prognosis of different types of fistula. Method..A retrospective analysis of 42 cases （43 ears） with laby- rinthine fistula in our hospital from January 2007 to November 203.4 was conducted. Data of preoperative clinical manifestation, auditory function, CT image, operative findings, treatment and postoperative recovery were col- lected and statistically analysed. Result： Thirty-nine cases （40 ears） of the 42 cases （43 ears） which were diagnosed as labyrinthine fistula according to operative findings occurred in the lateral semicircular canal, 1 case occurred in the posterior semicircular canal, 1 case occurred in the superior semicircular canal, and 1 case occurred both in lat- eral and posterior semicircular canal. Before operation, 24 ears （55.8%） experienced vertigo and 14 ears （32.6%） showed impaired bone conduction hearing threshold. According to Dornhoffer classification standard, 22 cases （23 ears） were diagnosed as type Ⅰ fistula, 9 cases as type Ⅱ fistula and 11 cases as type Ⅲ fistula. There was no statistical difference among the 3 groups on type of hearing loss, vertigo, CT, facial nerve canal damage before op- eration and bone conduction hearing threshold, vertigo after operation. Conclusion：An accurate diagnosis of laby- rinthine fistula relies on the operative findings rather than preoperative clinical manifestation, auditory function or CT The surgical intervention should be individualized. There is no significant difference on postoperative recovery among different types of labyrinthine fistula.

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