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良性阵发性位置性眩晕经药物治疗无效丧失劳动能力者可行手术治疗。Schuknecht认为引起该症状的病变位于后半规管壶腹中。Gacek 1974年报告经扩大的骨性外耳道,在圆窗下方钻洞,于单孔管中切断后壶腹神经,可以缓解致残性的眩晕。Silvrstein报告14例单孔神经切除术,采用耳后切口经扩大的外耳道暴露较为方便。这类手术方法容易损伤圆窗膜而导致严重的听力损失。本文作者改良手术操作如下:在全麻下先作普通耳内切口,沿外耳道后壁向上延长,从此切口下端向前作了鼓室的补充切口,在相当于骨性外耳道外缘深度绕到外耳道前壁中部。再从此切口的前端向外作一松解切口,把外耳道软骨切开约1.5cm长。剥离切口外边的皮肤和骨膜,用特制牵开器将外耳道软骨部向下牵开,露出约2cm宽的骨面。外耳道后下壁皮片连同鼓膜向前翻至槌骨柄处,折向鼓环前沟。如同下鼓室进路作颈静脉球体瘤手术方法,扩大骨性外耳道下壁,这样可以到达圆窗区,与外耳道约斜成30°角。要
Benign paroxysmal positional vertigo invalid by medical treatment incapacitated those who are viable surgical treatment. Schuknecht believes that the symptoms of the disease in the posterior semicircular canal ampulla. In 1974, Gacek reported expanding bony external auditory canal, drilling a hole under the round window and cutting off the posterior ampullary nerve in a single-hole tube to relieve disabling dizziness. Silvrstein reported 14 cases of single hole resection, the use of ear canal incision enlarged external auditory canal more convenient. Such surgical methods tend to damage the round window membrane and cause severe hearing loss. The authors modified the following surgical procedures: Under general anesthesia for ordinary ear, along the posterior wall of the ear canal upward extension, from the lower incision made a tympanum forward incision, equivalent to the depth of the outer edge of the external auditory canal outer ear canal Central. Then from the front of the incision outward for a release incision, the external auditory canal cartilage incision about 1.5cm long. Peel the skin and periosteum outside the incision, with a special retractor to open the external auditory meatus cartilage downward, exposing about 2cm wide bone surface. After the external auditory canal, the lower wall skin flap together with the tympanic membrane turned over to the shank, folded to the front of the drum ring groove. As the tympanic approach for jugular bulb tumor surgery method, expand the outer wall of bony external auditory meatus, so you can reach the window area, and the external auditory meatus oblique angle of about 30 °. want