目的 探讨治疗中耳炎合并迷路瘘管简单易行的处理方法.方法 回顾性分析我科在2004年6月～2010年6月间中耳炎手术1226例,其中54例55耳伴迷路瘘管,分析其临床特点、手术方式、效果.术后随访1～5年,观察病人有无复发及听力、平衡障碍的变化.结果 在1226例中耳炎患者中合并迷路瘘管的54例55耳(4.4％),54例患者均一期手术,根据情况选择筋膜覆盖或者筋膜填塞.术后3个月,所有病例均干耳,术腔上皮化(100％);手术后无眩晕发作9例(16.7％),眩晕持续1周以内缓解19例(35.2％),2周以内23例(42.6％),眩晕持续3月3例(5.6％).有术后半年纯音听阈记录的患者38例,与术前比较听力无变化的18耳(47.4％),较术前提高的有9耳(23.2％),术后随访1～5年胆脂瘤及瘘管均无复发.结论 单纯筋膜填塞迷路瘘管的方法,与文献中介绍的方法比较,简单易行,风险小,手术并发症少,对听力无明显干扰,值得推广应用.%Objective To present the authors' experience with surgical management of labyrinthine fistula caused by chronic otitis media. Methods Between June 2004 and June 2010,1226 patients affected by chronic otitis media were operated upon by the authors. Among these cases, 54 (55 ears) were complicated by labyrinthine fistula and retrospectively reviewed. In each patient, clinic features and type of surgery were evaluated. Results The rate of labyrinthine fistula in the 1226 patients with chronic otitis media was 4.4%(54 cases). In all of these cases, primary repair of the fistula was achieved through fascia sealing or fascia filling based upon the condition of the particular lesion. After 3 months, all patients showed dry ear and complete surgical cavity healing (100%). Post-operatively, vertigo was absent in 9 cases (16.7%), resolved within 1 week in 19 cases (35.2%) and within 2 weeks in 23 cases (42.6%), but persistent in 3 patients (5.6 %). Hearing records six months after surgery were available in 38 patients. Hearing levels were unchanged or improved in 71% of patients. Favorable outcomes were obtained in all patients without recurrence inl-5 years. Conclusion Fascia filling for labyrinthine fistula is a simple technique worth frequent application.
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