胆脂瘤手术后采用骨替代材料行乳突腔填塞：81例9年回顾性经验
Mastoid obliteration after cholesteatoma surgery with bone substitute mastoid obliteration: A 9-year retrospective experience of 81 cases.
文献信息
| PMID | 42900196 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Salomé Defaye |
| 作者单位 | Department of Otolaryngology-Head and Neck Surgery, CHU Dijon Bourgogne, 21000, Dijon, France. sdefaye@icloud.com. |
| 期刊 | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
引言： 本研究旨在评估在胆脂瘤手术中使用骨替代材料行乳突腔填塞的疾病控制情况和功能结局。
材料和方法： 本回顾性研究纳入2014年3月至2023年3月期间接受手术的81例成年患者。所有患者均接受使用骨替代材料的乳突腔填塞，或在开放式乳突根治性胆脂瘤手术中同时行外耳道重建，或用于修复既有的乳突腔。所有患者均有18个月随访，包括耳镜检查、听力测定、CT扫描和/或MRI。采用STAMCO分类描述病变范围。平均随访时间为34.5个月（中位数28个月；范围：18-112个月）。
结果： 在末次随访时，80例患者鼓膜健康且愈合，1例患者存在持续性穿孔。手术前后平均气导纯音听阈无显著差异（分别为51.8 ± 18.8 dB vs 53.1 ± 21.4 dB；Wilcoxon检验，n=77）。术后平均气导和骨导阈值以及气骨导差均保持不变。在本系列中，听力测定结局不受STAMCO分类或手术类型（初次手术 versus 修正手术）的影响。1例患者出现残留胆脂瘤，未观察到复发性胆脂瘤病例。
结论： 在胆脂瘤手术中使用骨替代材料行乳突腔填塞可获得良好的解剖学结局、较低的并发症发生率并保留听力。在缺乏对照组的情况下，这些结果支持该技术的安全性，而非已证实的复发率降低；需要比较性研究来确认其对疾病控制的获益。
英文摘要
INTRODUCTION: The aim of this study was to evaluate disease control and functional outcomes of mastoid obliteration using bone substitute material in cholesteatoma surgery.
MATERIAL AND METHODS: This retrospective study included 81 adult patients operated on between March 2014 and March 2023. All patients underwent mastoid obliteration using bone substitute material either during canal wall down cholesteatoma surgery with external auditory canal reconstruction or for rehabilitation of a pre-existing mastoid cavity. Follow-up at 18 months, including otoscopy, audiometry, CT scan and/or MRI, was available for all patients. The STAMCO classification was used to describe disease extension. The mean follow-up duration was 34.5 months (median 28 months; range: 18-112 months).
RESULTS: At the last follow-up visit, 80 patients had a healthy and healed tympanic membrane, while one patient had a persistent perforation. There was no significant difference in mean air conduction pure-tone average before and after surgery (51.8 ± 18.8 dB vs 53.1 ± 21.4 dB, respectively; Wilcoxon test, n=77). Mean air and bone conduction thresholds, as well as the air-bone gap, remained unchanged after surgery. Audiometric outcomes were not influenced by STAMCO classification or by the type of surgery (primary versus revision) in this series. One patient presented with residual cholesteatoma, and no cases of recurrent cholesteatoma were observed.
CONCLUSION: Mastoid obliteration using bone substitute in cholesteatoma surgery achieves favorable anatomical outcomes, a low complication rate, and preservation of hearing. In the absence of a control group, these results support the technique's safety rather than a demonstrated reduction in recurrence, and comparative studies are needed to confirm its benefit on disease control.