Evaluation on Combined Effect of Microscopically Radical Mastoidectomy and Nd∶YAG Laser on Middle Ear Cholesteatoma
Objective To explore the combined effect of microscopically radical mastoidectomy and Nd∶YAG laser therapy on middle ear cholesteatoma.Methods Totally 100 patients with middle ear cholesteatoma treated between May 2022 and May 2024 were selected and divided randomly into an experimental group(n=50)and a control group(n=50).The patients in the experimental group were treated jointly with microscopically mastoidectomy and Nd∶YAG laser.The laser carbonization power for the mastoid surface bone was 20-30 W,and the gasification power for the cholesteroma,mastoid,tympanic sinus and upper tympanic cavity was 40 W.The patients in the control group were given microscopically radical mastoidectomy.For the patients of both groups,bone conduction hearing threshold and air conduction hearing threshold were measured respectively via pure hearing tests,and tinnitus handicap inventory(THI)was used to assess tinnitus before and 3 months after the surgery.The higher the score was,the more serious the tinnitus symptom appeared.In addition,dizziness handicap inventory(DHI)was used to assess dizziness for both groups of patients.The clinical effect for the two groups of patients was determined according to the healing of eardrum,patency of eustachian tube,ear symptoms and the change of pure tone hearing threshold.The changes to the levels of such indicators of ear inflammation as serum hypersensitive C-reactive protein(hs-CRP),malondialdehyde(MDA)and superoxide dismutase(SOD)were detected before and 12 days after the surgery and the complications induced in the treatment were recorded.Results Three months after the operation,the bone and air conduction hearing threshold and THI and DHI score of the patients in the experimental group decreased more obviously than those of the patients in the control group.Twelve days after the operation,the levels of hs-CRP and MDA were significantly lower in the experimental group than in the control group,and the SOD level in the experimental group was apparently higher(P＜0.05).The total number of effective cases in the experimental group was(94.0％),which was much greater than that in the control group(P＜0.05).The total number of the patients with complications in the experimental group was 3(6.0％),which was much smaller than that in the control group(P＜0.05).Conclusions The combination of radical mastoidectomy under microscope and Nd∶YAG laser treatment will improve the clinical symptoms of the patients with middle ear cholestatoma and reduce their inflammation and complications.
LaserMicroscopically radical mastoidectomyMiddle ear cholesteatomaIndicators of inflammationClinical effect
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