Clinical Analysis Of Stage Ⅰ 0ssicular Chain Reconstruction In Middle Ear Cholesteatoma

Objective:For cholesteatoma of middle ear(come),the thorough removal of the lesion and the feasibility of hearing reconstruction are the problems that every otologist must face.This study mainly introduced the application of titanium artificial ossicles in come operation,followed up the dry ear time and postoperative hearing improvement of patients,and carried out univariate analysis of its related factors,in order to provide clinical guidance for the operation of come.Method:From November 2018 to August 2020,60 patients(ears)with unilateral come were treated in our department of otorhinolaryngology.T test and chi square test were used to compare the clinical data(age,gender,course of disease,side of disease),preoperative hearing,postoperative dry ear time and postoperative hearing improvement of the two groups.According to the different types of radical mastoidectomy,the experimental group was divided into the open wall down(CWD)group and the wall up(CWU)group.T test was used to compare the preoperative hearing,postoperative dry ear time and postoperative hearing improvement between the two groups.The exact probability method was used to test whether eustachian tube function,stapes and tympanic mucosa affect the effect of ossicular chain reconstruction.Telephone and outpatient follow-up were used to collect the outcome.Result:There was no significant difference in clinical data between the experimental group and the control group(P > 0.05).2.In terms of preoperative hearing,there was no significant difference between the experimental group and the control group(P > 0.05),and there was no significant difference between the CWD group and the CWU group(P > 0.05).3.In terms of postoperative dry ear time,there was no significant difference between the experimental group and the control group(P > 0.05),but there was significant difference between the CWD group and the CWU group(P < 0.05).4.In terms of postoperative hearing improvement,there was significant difference between the experimental group and the control group(P < 0.05),but there was no significant difference between the CWD group and the CWU group(P > 0.05).5.The main factors that affect the curative effect are:eustachian tube function,stapes,tympanic mucosa.Conclusion:1.Compared with open radical mastoidectomy,there was no difference in dry ear time after tympanoplasty with titanium artificial ossicles in radical mastoidectomy.2.The use of titanium artificial ossicles in the tympanoplasty of patients with come has a positive effect on improving hearing and the quality of life of patients.3.There was no significant difference in hearing improvement between CWD group and CWU group,but the dry ear time of CWU tympanoplasty was shorter,so CWU should be chosen as far as possible under the condition that the patients’ indications met and the surgeon’s technology was mature.4.The factors that affect the outcome of ossicular chain reconstruction include eustachian tube function,stapes and tympanic mucosa.We should understand these factors before operation and make appropriate treatment plan.