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[The application of mastoid cavity plombage in open method tympanoplasty]
1Department of Otolaryngology, First Affiliated Hospital, China Medical University, Shenyang 110001.
Objective:
The role mastoid cavity plombage played in restoring physiological function of external meatus in open method tympanoplasty was studied.
Method:
85 cases of cholesteatoma otitis media were performed open method tympanoplasty with the broken bits of their own mastoid process cortex, homological costal cartilage or U shape periosteum connective tissue valve. And plombage was performed at the same time. The reconstruction of ossicular chain (type 0 tympanoplasty): 10 ears did not undergo reconstruction due to increase ment of bone conduction threshold or were in preparation for the second phase operation; 40 ears underwent type III tympanoplasty; 35 ears underwent type IV tympanoplasty.
Result:
The total improvement rate of hearing was 76%, among which 80% were performed type III tympanoplasty and 71.4% underwent type IV tympanoplasty. After operation, the time waited till dry-ears was 19.8 +/- 65.31 days and the dry-ears rate was 97.6% (83/85). Six months after operation, 89.4% (76/85) had smooth external meatus and fine self-cleaning function and no recurrence was found.
Conclusion:
As to cholesteatoma otitis media that could not be performed closed method tympanoplasty, U shape periosteum connective tissue valve and mastoid process cortex were used. Mastoid cavity plombage with homological costal cartilage could effectively overcome the shortcomings of destruction of physiological structure of external meatus caused by open method tympanoplasty, the self-cleaning function of skins of external meatus was remained and the life quality of patients after operation was increased.