Clinical Research Of Multiple Technical Comprehensive Use In The Operation Of Chronic Otitis Media

Objective To study how to use multiple techniques to clean out focus,to reconstruction sound conducting structure in the middle ear,to improve listening and to prevent recurrence.Methods 50 patients(50 ears) with chronic otitis media who came to department of otorhinolaryngology in the first people's hospital of hefei during Jan 2009 to Jun 2010 were involved in this study.All of the patients underwent Y type incision in the ear,use gas drill,milling drill, pendulum saws and ear microscopic surgical instruments.On the basis of clean out focus of the patients,according to the disease of patients,Bone cortex of external auditory canal- papilloma was used to reconstruction outer reveal of attic,external auditory canal and ossicular chain. The chorda tympani nerve was used to support ossicular chain.External auditory canal- papilloma periosteum was used to repair the eardrum by sandwich method.Give the patients regular follow-up,and review their pure hearing threshold.Contrast the differences between preoperative ABG and postoperative ABG by self-control study.Results Among 50 patients with chronic otitis media,hearing thresholds of 44 patients were improved about 10 to 30 db compared with preoperative hearing thresholds,the success rate of operation was 88%.The average number between preoperative ABG and postoperative ABG of 50 ears in speech frequency was 17.67±14.63dBHL, use Paired-Samples T Test,p<0.01, It was a statistically significant which prompt the hearing of patients improved obviously.During the long-term follow-up,45 ears(90%) have normal external auditory canal,middle ear cavity with containing gas and normal eardrums.During these 46 ears,postoperative ABG of 18 ears(40%) were less than 10db, postoperative ABG of 22 ears (49%) were less than 20db,and postoperative ABG of 5 ears(11%) were more than 20db,but the hearing curve of 3 ears in these 5 ears improved 10 to 30db compared with preoperative curve.Conclusion In the operation of chronic otitis media,mutiple technical comprehensive use can reconstruction sound conducting structure,external auditory canal and outer reveal of attic on the basis of clean out focus,it can maintain the normal form of middle ear,improve listening and prevent recurrence.