关键词: 胆脂瘤；鼓室成形术； 外耳道重建；自体皮质骨

Abstract:

Objectives   To evaluate the therapy of canal wall down tympanoplasty and canal reconstruction with homograft cortical bone plate.  Methods   Retrospective case review. All 49 patients were divided into 2 groups. The experimental group included25 ears underwent canal wall down tympanoplasty and canal reconstruction with homograft cortical bone plate， while the control group included 24 ears underwent regular canal wall down tympanoplasty with canal reconstruction. Follow up lasted 6～36 months and postoperative hearing and dry ear rate were evaluated.  Results   The criteria for success were defined as AB gap closure over 15 dB HL or air conduction threshold less than 40 dB HL (using the mean of 0.5-, 1-, and 2-KHz threshold values). The experimental group's effective rate was 68%(17/25)and the control group′s 62.5%(15/24). No significant difference was found between two groups(χ2=0.1635， P＞0.05). The dry ear rate of experimental group was significantly higher than that of the control group(92% vs 58.33%, χ2=4.3636, P＜0.05) Patients of experimental group showed normal postoperative external auditory canal  without closure or stenosis.  Conclusion   Canal wall down tympanoplasty and canal reconstruction with homograft cortical bone plate has advantage in retaining physical structure of external auditory canal and middle ear, with complete removal of lesions and is more efficient in improving hearing and obtaining dry ear.

Key words: Cholesteatoma；  Tympanoplasty； Canal wall reconstruction；Homograft cortical bone plate