脂瘤

AIM: To improve the diagnostic level and surgical curative effects of cholesteatoma in the posterior fossa.

目的：为了提高颅后窝胆脂瘤的诊断水平与手术治疗效果。

Results CTVE could clearly demonstrate the shape,size,and relation of the normal auditory ossicular chain.A visualization rate of malleus,incus,and incudomalleal articulation was 100%,and was 32% for the stapedial footplate.However,in only 21% could the anterior and posterior crura of stapes be distinguished.Cholesteatoma was found in 12 cases with chronic otitis media,in which CTVE demonstrated varying degrees of destruction of the auditory ossicle.In 1 case with congenital anomaly,ossicle dysplasia was seen.

结果 CTVE能清楚显示正常听骨链的形态、大小及相互关系，锤骨、砧骨及锤砧关节的显示率为100%(38/38)，镫骨底板的显示率为32%(12/38)，只有21%(8/38)可以分辨镫骨的前、后脚；18例中耳炎患者中12例胆脂瘤形成，CTVE上有不同程度的听小骨破坏。1例中耳畸形显示听骨链发育异常。

Results: Both MIP and SSD 3D images could direct display the shape, size and correlation of malleus and incus, the incus-stapedial joint was like"L-shape" structure, but it was difficult to exhibit the footplate, anterior and posterior crura of stepes.Cholesteatomas was found in 12 cases with chronic otitis media, that 3D images exhibited varying degrees of destruction of the auditory ossides, and the display ability of SSD 3D image was slightly better than that of MIP 3D image.

结果：MIP和SSD 3D重建都能直观地观察锤、砧骨的形态、大小及相互关系，砧镫关节呈"L"形，镫骨前后脚及底板显示欠佳。18例中耳炎患者中12例胆脂瘤形成，3D重建显示有不同程度的听小骨破坏，SSD 3D的显示效果略好于MIP 3D。

Methods The operative findings in 91 patients who underwent revision mastoid surgery were analysed.

乳突根治术后的胆脂瘤复发或残留在临床上较为常见。

The disease can progress to extensive mastoid destruction.

外耳道胆脂瘤可能发展成广泛性的乳突破坏。

Results The main cause of recurrent and residual cholesteatoma was the uncomplete primary mastoidectomy,the revision mastoid surgery was performed in 86 ears and the tympanoplasty with mastoidectomy was performed in 10 ears;82 cases were followed up from 1 to 11 years,in which 5 cases recurred.

现分析91例（96耳）乳突再根治患者的临床资料，讨论其胆脂瘤复发或残留的原因、再手术时对听力和病灶的处理原则等。1 临床资料资料来源于北京同仁医院耳鼻咽喉科1987年1月到1996年12月的住院患者，共91

Methods One-stage mastoidectomy and tympanoplasty with ossicular chain reconstruction using postauricular musculo-periosteal-bone flap was completed in 47 cases（47ears） of cholesteatoma.

对47例（47耳）胆脂瘤中耳炎病人，在清除病变的同时一期行鼓室成形术，用耳后带蒂肌筋膜骨瓣修复听骨链进行听力重建。

One- stage mastoidectomy and tympanoplasty with ossicular chain reconstruction using postauricular musculo -periosteal- bone flap is a practical way to improve hearing and prevent cholesteatoma recurrence.

鼓室成形术中用耳后带蒂肌筋膜骨瓣修复听骨链行听力重建，能有效改善听力，降低胆脂瘤复发率，是一种较为实用的手术方法。

No any hearing decreased case was found compared with that in preoperation. Conclusion One- stage mastoidectomy and tympanoplasty with ossicular chain reconstruction using postauricular musculo -periosteal- bone flap is a practical way to improve hearing and prevent cholesteatoma recurrence.

鼓室成形术中用耳后带蒂肌筋膜骨瓣修复听骨链行听力重建，能有效改善听力，降低胆脂瘤复发率，是一种较为实用的手术方法。

HRCT can correctly diagnose and orientate mastoiditis, but can not easily distinguish granullomatous from cholesteatoma.

由于HRCT能清晰显示颞骨结构，对中耳乳突炎性病变发现及定位较准确，对胆脂瘤和肉芽肿型鉴别仍有一定困难。

For a big chunk of credit-card losses; the number of filings (and thus charge-off rates) would be rising again, whether

年美国个人破产法的一个改动使得破产登记急速下降，而后引起了信用卡大规模的亏损。

Eph. 4:23 And that you be renewed in the spirit of your mind

弗四23 而在你们心思的灵里得以更新