山东大学耳鼻喉眼学报 ›› 2024, Vol. 38 ›› Issue (3): 82-87.doi: 10.6040/j.issn.1673-3770.0.2023.189
• 论著 • 上一篇
高欣妤1,周函2,刘丁丁2,陆玲2,陈杰2,钱晓云1,2
GAO Xinyu1, ZHOU Han2, LIU Dingding2, LU Ling2, CHEN Jie2, QIAN Xiaoyun1,2
摘要: 目的 探讨中耳胆脂瘤伴高位颈静脉球的临床表现、诊断依据以及治疗策略。 方法 回顾分析1例中耳胆脂瘤伴高位颈静脉球患者的临床资料并复习相关文献进行总结。 结果 术前耳内镜及CT预判高位颈静脉球达中鼓室,手术采用耳内镜水下操作模式,彻底清除胆脂瘤、掀起松弛部和紧张部后上方内陷袋,去除被部分破坏吸收的锤骨和砧骨残体,镫骨上结构消失,底板活动正常。掀起外耳道皮瓣分离鼓环的同时避免损伤颈静脉球,2.5 mm全听骨链赝复物重建听骨链,耳屏软骨筋膜瓣修复。 结论 中耳手术术前除了评估乳突及鼓窦、听骨链、面神经之外,还应充分评估颈静脉球情况,以免术中大出血等严重并发症。耳内镜水下技术对合并有高位颈静脉球的中耳胆脂瘤有独特优势。
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