【doc】耳内镜在耳与耳神经外科临床的应用

【doc】耳内镜在耳与耳神经外科临床的应用 耳内镜在耳与耳神经外科临床的应用 2003???O1???O1?! ?????????N?? ?kX????}?kFv?k?????9??FP???????} ????F???&!?? ???YX??K?K???k?K???????M???~(?6F?100553) ?T??F? F?N2?kX?????X? ?9???????????h?H?V(minimallyinvasive surgery)?V21F9?????????????????l?V???????? ????F????????H?V?????l?}??F????????V???!?? ??????X?Fa?l??X?N2?9???}?1??X????????h???V ???w?1???H?V???????T?l?"??F?&4?????H?V?M ???lX??c?5?VFyF??????]??????X?X??????i?Z?N ?????(???????l????_%???]?_??&????????????D ?c?????????l?lFM?H?V???????lX??u???~???l?G &F?H?V???????????!??????F????y?????l&????? ?(???????y?l?????(?U??????N0 ???~?k???k?????Y???H?V???V??X??????V?? ??_??????V???????l&??k???????????????????? ???????l??X???N0?kX??????V?V?????}F??k?Y?? ???????9????F?????????N0Me:?b????1967??) ??XZ???}X??????V?????g??N0???X(1982)???} 4o?????k??4[???wF?Ff?kX????????VN0???vF? (1983??)??XZ?)X?F?X????}????Ff?k???i???? ?0?-?y??Ff??&??}N01993??Thomassin['!???????9 ?k????Ff?kX????k?9?????}?????q???????0?- ???l?????????!???;48%?G&F?N6%. ???G?}F??k????X????i????X?????????X??? [z-sl?l?i&??????????????l?i?D?}??0N2300, 700,90-?l??Fy?D?}??5',250,550,80?bFy?l?? ??N0??Fy?l???M???wX????V?l???(???N?????NFf ?k?1FC?????lX?FfF???30N0??X?????&??????????l&R ?????9?k???M???????vFn?g??????F?????N2?g?? ?M???????v?g???l?8F?90,X??????0?m?l70??U???? ???}F?????F????V??Fn???9Fa???l??????Ff???M ???l&??}300??90,X?????00X??????i?IF?????N0 ?????????v?9F??????v?????8F?300,700Fc&? ?}F??????g??X????i?????g????N2???_???g &??(??F?:??F??l???lFKF??K?mN2???? ??????????Xb??X???N0?????g?????lX??9??F? 1.7mm???}F??9?k???????l?}F??O????Fy?????? ?N?g?????g??????&?N0 ???_???g?????l????????6.8mm?I?}?????9 ???D???s?N?????N??FC?g?????(???????l?_???? ??2.7mm?l?(??300,700????N0?_????????F??? ??Ff?l?????????????l?V?(???????N?1FC???d?l ?l???l??&??V?(X????????????j??????????N0 F??O????1.2mm?9???l????00?l?9?? 1.9mm?l????300,700??900N0???~????Xb?????V ???????l?????????kX???[]04847}?l???x?1?0?l??&? ?9???i0.5F?l2mmFy?b?l???G?T?i0.35mN0?9?? ?k?6??X?????????N0??&??????l?~????Xb?????? ???T?l?????;???(???lF??O???sF?1.2mm?l?sF? Imm??&??l&?F??T?????g???????l?0?m?????g?? ????Ff?k???????????l???????g????F?Ff?k?g?? ???l?????g?????????l?????i550,7019??N0?k?6 ??X????:??Fa??????Xb?9?????i???}F?F????k?6 ?yF??VNl1zF?47510 ?kX?????????: 1.?kX???X??i?1??Fy?l??????N2????????N2 ??Fy?l??????X?????????X????l?kX????????????? ?c???A???/_??????l??Ff?kN2?k?????~???b???d?l?? ???}????????????????&??`?5???s?????q?l?-X??V ???Y????FaFy??????????&G(????????????N2?g?? ??N2???g???????g????N2?v?g?????b)?l?E?????(?l?" ????????X??l????X?&?????N0 2.?kX???X??i?????l???????lXb?!?vF??l?? ???(???l?5?????c?l???????M?l???????PFy?l?? ?????1?lF??s???U?l&??}??&?N2??X?N2???}?l?? &-?s?b???NFH?1 3.?kX??????????????c???A???/_??????l?? &?FP???/???????V?l?????????M???}N0???????l ?kX????}?k?????k?????9???????}?l???????N?? ???????l???9???t???????S??X?F??????i?????l ChineseJoumalOfOtologyVal.1No.12003 ?????VF???Fc?e????????N0?kX??????V???}F??? ?a??Fn?"??&4???????????H?V???sN0?kX???&?Fc F????????H????X????eFc?k?Y???9??N2?k?????9 ?????hN2?????H?V?????????e???5N0??F??KX??? ???}FP???????????}?l?i?i?}?????KX?????F??k X????}F?Ff?k?????????????}F?X??O??N2???s?u ???H?V?????????Z??N0 ?kX????c??:(1)???}F??H?2???l???????H ??&?;(2)?VFf????Fy???N?(?????P?~???l?G?? ???2???????(??;(3)?H?V?????????????????? ???l??XZ???????k???k??????X?????X??????\X? ???????0?DFf?k?Y??????????Ne-,q]l91?l?VFf?G??X? ????????????????????X?????&????V???????? Ff?kX???FP?????} Ff?kX????l??F????s?iFi???M????:???????? ???}???g???????l?9???????g?????g???)???v?? F??l?9?????g????F??l?1???????M?????M???l?] ?]????F?FP?????????l??XGF?F?F?Fy?????????Y ?H?VN0 ???m??X?N2?9???t?????l???GFf?kX???FK?? ?}F?F?Fa????????????????N0 1?5???]Ff?k??12a21]:?kX????}F??5???]Ff ?k???l???????????g???)?:?g?????c?l???N???? ???9aF??????????9???g???)???D?:?l?9?????V; F??????g???)????F??g???l?????g???????(?l?? X??????l?????????????1?w?????????l??F????5 ???]Ff?k?????a?????5???2?`?5?i?}N0???s?D?: ??F??O?}2.7F?8kPa?l???"???5???????4??N2???( ???e?????l???l?D?:?????j?}5.3kPa?????l???? (??????10.7kPa)?g??&-Ff?k???D?????l??&FF? F?2.7kPA?l?8??Fy?N?D?:&??}N0 2.???]?9?g?]Ff?k??4[,20-35j (1)?kX??????}&?Ff?k?????????????lF??D ??????92%a?l?????N100%111?l?kX?????????&??( ???Y?]??_??l????F?Fy?l???????????d??&G???g ???????l???m??F????v?YFn?EN0?kX???Fa?????w X??6N2?D?gN2???????????0?-?b???????????g?? &????V[20,2q(2)?kX??????g?????????????lF??!???D?: X????5???0?-?lX?F?3%???]?PN20.5%?q?????? X??6Fn?g??F???1F?2?%?l?????kX???Fa??Fn?g?? ?????0?-?5???l?????~??X??6?????N???k?l???? ?V???????!???D?:???DX?Ff?k????N2F???N2???g ???5?????l????X??6X??g?????d??&GFn?g??N2?g ????N2?v?g?????b?1?????l&R?????s?????D?:X? ?6F??0?}F??~?_F????g???s?????0?-?????(N0?? ????XG?H?V?~?U???O?????????l????F??!?K??&? ?V?`?5??????????N0&R?????yX??6????Fy?????? ?(???(?lF????H?VN0???]?????0?-?????]?9?g?] Ff?k???l?i????N2?I???(??X\???????}?!???D?: ??N0 (3)?kX????9X???????Fa??Ff?kF????H?V f21F?2?l] ?????sF????H?V(??&????9?k???v??)?l?V ?v???d??&?Ff?kN2X??k??&4??????&??2???D?l&R ?V???)?-??????_&???lBPDN0?????????s?H?V???) ?-???????????y??????Fc???Y?s?"???V??6_y?l Thomassin"'???S?}?????s?H?VFf???}X?????&??? ?0?-???????;48%?G&F?N6%N0?;F??????s???g ??F????H?V?lFK???????V?;F?&????9?k???v???l ???T???d??&G?????)?-?}?Y????Fa???????????? ?(???l???????y???!?lFcF???X???FC?????l???T &??(?}?????s?H?VFf???}?kX????t????????F??} ?Y????FaFy??????????&G?lF??q?????0?-?????? ?y???l?????????Z??Nls2-251N0???}?kX???F?F????? ???g??F?FC???u?l????Ff?k???)?-????&G???u?? ??????????X?N0XZ?}?Y????Fa??????????X??lX? ?}X??????s?????l?g??N2?g????N2?v?g?????l?? ????????N2????????N2Fa?g??N2Fn?g???G????N2 ?k?????g????Fa?g???b??&G?l?i?????)?-?????l ??????????????F??????(??N0?"??X?&???X??l?} ?Y????Fa?9X??????eFy?l???????g???e???VN0?? ???g???????v?g???????l?????`?5?(??????N0?? ?GX????????H?V???eFc??X??????s?H?V???0?-?? ?????y??????Fy???c?u?????i?Z??????N0 X???Fa??????F??%???Y?H?V???Y????Fa???? ??X?F???N0???9?s?????0?-????????X????????? X??lFy??X??w???Y?s?H?VN0 (4)?kX??????}F??????sFf?kF????H?V?v?? F??!?????H?V?lX??H?V?????V?}???k?v?)??Ff?? ?????c?9&?F?1.Ocm?s?)???l?5X????:F?F??? ???l?5?J?}1.9mm,2.7mm;4.Omm??Oo,30o, 70N0???kX???????F?????N2?g??N2Fn?g???l?????? ??????????F??????9?????U?b?????????}?????? ?????lF??"??????N0?????????s?????0?-???}X? ??Fa?)??N0?j?v&?F??s?g???)???l??F?1.9mm?? 00X???????Ff?k???l???????NF???N2??????????Fa ?g???l?????i?????0?-?y??N0????????Ff?????] ?? F? 2003???O1???O1?! ?????)?-?l?8?"Fc?k?v?)???l?w?)X???F????"?? ?VN0McKennan["?l??FcX????}F??????s?H?V?v?? 4oF??!????4[?l?H?V????F??I???H?V????????X? ?u?H?V???????l?s?????0?-??F??l???)???l?lFy ?????w???Y?s?H?V?l&R???]???0?-?v????&G???3 ???vF????"Fc?D???H?V?l?G???????(??????N0 3.?kX??????O?????????????? ?kX??????g???M???l???????N?????l?????? X?Fn????N2?]??????N2?]??X???N2?,??X?N2???? ???tN2?v?g????N2?g????N2?g?o?s??N2?g??Fa ?T?l?????????l?g???GN2?v?????g???GFa???b?? ??N0?}???]Ff?k????F??l?V?(?????g???????? ???lF????N?g????????X????O???????&?a??N0?? &4???]?k?H?g???????(?l???w?g???)??&DF?30?? 700X????l?????????l???(???Y?c?1?O???????m ?b?l?T???v???????l?"??X?&???X??????H?V?? ??N0 4.?9?????s[x6,271 ?;F??????????~????F??????P???lMondini?b XZ?I?]FfN2X??k?????l???9?????s?l?PN2?k???9 &-?9?????????v?l?9????&??!???????]?k?H???I ??????Fy?(?(?l?9????F????????????????]?k?H ?(?l?9?K???]?9?????s?l???????H?V?9?VFf???? ?????????;&G?9X????l?k?????9???H?VN0?T?i?? ?T??F?????Fy?v???9?????s?bN0???????i?9???? ?s?(?l???w?k????X????????V?l???g???????(?l ?}?g???????}?g???????L?v?l?}?g???v???_???? F?F-??FH?????g??&?F??s?)???l?}????lmN0???? ????X??????g???)????F??g???????????????(?} ???&?M?l?9?(??????&???X????i?l?????!?????? ???9???lF???????N0???w??????????F??O?TFyFK ?4?k?????1?????lF??q??????F??g???l?l????Fc ?V?9?????sN0 5.??????&P?i?9&-?]???JN2?u?n???k?s?l ???}Ff?kX??????g?????????w?g?????????v???? ?!?}???????P????????F????O??????&-???;&G?? ??X?N0???????V???g????N2????N2?k????????F? ???????;&G?4?e???u?n???k?sF??i?v??????&G?s FbN0???i????????Ff??F?F??????m?????w?????? X??aX????V?lF????}?kX???Fa???????????wXZ?f ?]???9???)?-?(??????????X????VN0?kX???Fa?: ?g???????w???????P??????????????X????V?l?? ?d??X??u?????D?????P?&?l??????&?N2?????lX? ?i???h???H?V?Z??N0Nv?? 6.???g??Ff?k????X???FP?????}Nl?:F??? KimuraF?1989?????%F???F??????g??Ff?kX? ???V?lYamaguchi(1994)"?l????T???1??Fy?lFf ?k?????????g??Ff?kX??????????????l?????v?? ?????V?}??????F?Ff?k???????i??????&7??N0?? ??????X??????????g???M????F?Ff?k???l??XH?y ???????????g??X?&????l?g?????b??F????????c ???l????????X????????i0.5F?1.2mm?0?m???g?? ?????!?5??????N0 ??&????V???????g???M?????l???}?~???9X? ??Fa???w?l??XZ?}?KX????:??Fa?l??F?0.8- 1.2mm???X???9?????????l????????X???X????? ??????F????g????Ff?k?l?j?v?5?????v???lX??? ????????N0????Ff???????sX???&???F??????&?? ?????????l?U?8X???????????F?????450?l????&7 ???????????}F?Ff?k??????????Ff?k?V?v????N0 &R???????????kX??????V???????l?????s?lXb?? ?;?l?????}Ff?k???~?1?}????&G???-???????l?~ F??K?!?}???}????F????(FH?G?l??XZ????F?Ff?k ?????l???J?V?v?g?????g???GFa???????)???l?? ???(????&?????F??????]?)???l?G???-?????P?~ ?1??&G???lF?????????X??l?j?????????1?5?? ?ZN0?????????????kX?????Ff?k????F??B???g?? ???l?????s&???N0????X????????????3?????D?:N2 ???????l??&?F??H?V??&?N0 ?????g????????????X?????F??g???v?lX??? ???M?????N???c????Fa: ???g???4??_?Fn???gFn?g??F????g?????lF????? ???g???g?G?g?? ???g???4????Fa??F?Ff?g ????????Fn???]??X?&?F??g??F??? hr-???]???R?????9&??5?qx???? \??65oX???Fa??~?g???v????Fa?g?? ?}???????aFf?i3FC?????)????&????3: (1)??X?????X??G?g?????l??XZ?a?N???V?4?g?? ??_??l??Fv?-?????e750?"???lF????k&x????47`7 ??4[F????k&x??4o74[??;(2)??F?Ff?g?????? ???G?TFv?]???????e750?"???l&x4oL"???9?? L"??;(3)??F??v?g?????~???,????Fc?OFi ?)???l?????)????F??c?5?g????N2?v?g????N2?g ??&???N2????????????N0???g??X?????F?FnN2 FfN2?v?g?????g??F???F??????lX???????&????( ???????l??????????F??l?O?????????l&R?????? ???????l?WFy???t???????5?????P?????9????X? ??????N0 FiN2???h???????)???V???????e???V Chinese??umalOfOtologyVol.1No.12003 ??????????F????h???????)???V (stapedotomy)???????e???V(stapedioplastly)N0 Poe(2000)tz91?????????e???V?0?}F??????????G 1/3?s?3?????????l?}???s??????XbX????:??Fa ???v???????G???l?}?.???_??Xb(argonlaser)?M ?9?????G?????}???????????9???v???)??????F? ?????????v???l?G?????l???q?????5?}???????? ??N0???V????Fy?}?K???sF????,???l&????????? ?t???????U?lX??uF??K???V?sF??????????????V ?v?!???????]?k?HN2?I??N2???????????e???]?? ?&???????????????l&??????????t???????}???? Fa?????????J????X??u?O?????&N0&????????U?? ??XG?}???q?c????????Ff??X??k????&-?l?l???q ??&??}N0 ??N2X????}?A?_?k?6?yX??V?????} F?1996???OF??SF??C?A?_?k?6?yF?????&T Fn?l???i?k?6X??????VFP???}??????N0?}?k?6?y F??G???g?j??F?0.89mm???u??????X????????? ?NXZ?I?]?k?6?????l???D?????k?6??F??????9Fy ??X??5???l??MondiniX??k???????D???l???????? ????F?Ushers??Charge?b???m??N0?k?6?iFy?l?a ???????9?9???????e???6???????9?????b????N0 ????0.35mm??0.5mm?????u?]????X???????F? ????N0???wX????H?V?v?C?????iX??~????????&- ?b??X?????N0 Wang(2000)1'B?l?????}?k?6??X????:??Fa?5 C02??Xb??F??g?j?l?I?}??Xb?????9???M?9&??} ?????g?jX????????l&??g?j?y?T?l?bF????w?g?j ?e???V?lFc?g?j???9???(??F????k?6?g?j?A???y F??h?4??F?N0 ?????&(2000)"51M?????????0?]XZ?I?] ?HN2?u????N2????????N2?k???9??N2????XG???] ?!???????]?H?????x?????~???????????k?H???( Ff?l?k?6???5?9??X????9?D?D???!N0?????l?}F? ???k?6?A???yF??GXZ?w?k?6??X????????lF????g ?jX???X??l?i??F????k?6?yF??V???0?????l???B ????X??u???"?l???????k?6?yF??V???e????N0?k ?6X??????V???????l&?X??k?????V?GN2?VFf???? ?????eFc????N0 F?N2X????}?k?????9???????} F?1994??X????}F???X??H?V?iF????????PN0 Magnnan???SF??s?u???u???H?V???????l??X?F? F?1994??????X???Fa???u?s?u???H?V?????~??FP ???M???l?}???3???9?????????~Fn?h?}F?X???Fa ?????"X????V12.311-331 ?}F??k?????9????X???Fc4mm,00,300, 70o,900?b????N0X?????F??????v?????9?????v?? ??X????l?????,??????F?3F?4cm?l????????N24I ??????????F?X??O???c???????lX?????Fc?OVl?? ?????lX?Fn??FcFi??????N0X??O???c??X??????? ???????EF???F??jN0??X??i?1??????X??????,?? ?k?Y????Fa??F??-???9???v???~??Fv??????X? ???l?????(???Y?c?1??????FH????F?X????Y?]?? ??&??????l?IF??V?(?vF?????????&G???l??XG?V Ff??&-?l&?F??H?V??&??l?WX???????F??????v?9 ?????v???????w?T???k?????9???H?V?l???????? ?????x???????T??X????w?G???????)???VN0???? ???]?k?z?l?w?k?6?????)???VN0?kX????}?w?Y?? ?~??X????VFf??XH?y???T?Y????Fa?D???????q?? ???"?c??REZ?c?l????XW?5?Y?q?????"??REZ?c ??????&7???l??X??u???????????!???V?v????N0 ?W&?F??????????h?w?Y???~??X????V?l???????? ?5?VN2?l??????????Fi??????????????N0?}?O?? ???-?H?VFf?l???m???}?H?V?Y?????}???w???-?? ???G?l???????-Fv?????u????Fv?~????X???N0?? X??u??????????????&-?l???-?????v?l???}X??? ?????V???1FC???dN0?;F?X??O??????Fv???v???Z ?????l?Y????Fa?aFy?NIAC???9&?????X??k?? X??l?l300,700X???FyF????(?????a?NIAC?9&? ???l?T?????a?NX??k?????l?????V???i?????-?? ???????d??X??~??N0???uCT???u?~???4???E???k ?]?????(?l&RFP?????????iX??O?????s?u???u?? ?c?i??&G?]?????(?????wX??????????????K??F? ?v??????N0?????5X??????}F??k?????9???l???? ??X??O???c?s?u???u???????????l?H?V???????? ????X??????V???}?????????)??Fa?H?V??&??? ??N0?VFf????&??kN2X?N2???l??XGX??????]???W ???K???lFyF???F??????1?5?????lF???X??u???u ???????-?????????~??????&-?l???????H?V?} ???l?????H?V????X??]?lX??u?H?V????????N0 ???~X????]??Fy?????????l?k???K?!?e?e???? ???}?l???VF?FN?????????lX????5?????Y?cX????? &7???]?????NFH?1?l????&?Fc???k?Y???9??N2?k?? ???9??N2???hN2?????H?V?????????e???5N0?k??K?! ??F??????}?l?5?V?????k?????????P????F?FC???? ???a??N0???h?C???l???h?9???l?5???C????N2??Xb?? X????b???V?????m???5&????k???????9???????? ?P?????????????l&T?i???????PN0 2003???O1???O1?!59?l ???3???t 1.Thorn-sinI'd,Koachia,DohaJMD.Endoacopicguidedm.- surgerynthepreventionofresidualchnlesteatomas.lerynhgosenpe, 1993,103:939F?943 2.?!???&?!?9N0?k?K???????????5???????V?lFn??:?????? ??X??Z?Y?l1997 3.???????l?4?X?l?????lFf?k????X????????lFf?F?k?K?? ?V???L???l2002,37;58-59 4.Rosenbe,gSI,SilveretemH,Will-TO.Endoscopyinotology andneu-Wngy.Am.J.Otol,1994,15:168F?172 5.BonrillID,Pre,Ds.Endoscopyassistedearsurgery.Am.J.Otol, 1995,16:158F?163 6.EdeleteiaDR,MagnanJ,ParisierSC.Microfibemptieevaluation ofthenuddl,earcavity.Am.J.Otol,1994,15:50F?55 7.EdamatsuH,In-S,TominagaK?letal.Otosurgeryassisted withendo-pe..fOtalaryngolJpn,1999,9:323F?328 8.YamaguohlH.Directobas-ti..ofthetyarpamecavitybythe superfinefibers,??ythroughtheEustachiantube.NipponJibikoka GakkaiKaihq1994,97:90F?97 9.KlugC,FabinyiB,TschabitscherM.Endoseopyofthemiddle earthroughtheEustachiantube:anatomicpossibilitiesandlimita- lion.Am.J.Otol,1999,20:299F?303 10.???????????g??Ff?kX????V???????M????FP?????} NM????)?????9?K???????k?K???????5???l2002,3:149F?151 11.KimumH,YamagnchiH,ChengS,etal.Directobservationof thetympaniccavity?cthesuperfinefiberecope.Nipf,nJibiinkoka GakkaiKaiho,1989,92:233F?238 12.BalF?KenyT,FmdisM.Flexiblefibemptieendoecopyofthe cochlea:Humantemporalbane.studies.Am.J.Otol,1991,12:46F?48 13.WangZM,JiangY.CnchlearmicmendoscopyandC02laser vaporizationduringcochlea,implantation.Adv.Otorhinolaryngol,2000, 57:106F?108 14.KeutzkyM,SusamM,FromP,etal.Flexiblefibempticend- c??yandlasersurgeryinobliteratedco.Weas.LaserSurgMed,1996, 18:271F?277 ??F??????&?l??XR???l???Y???l?b?k?6?????????}???[?? ???S.Ff?F?k?K???????L??,2002,37:140F?141 16????F?Ff?k?Y?????????H?V???sFb.????&!???l???~ ?cFK?9.?P??????????????????.?6F?:F??uX??KX??Z?Y.2002 17.PmamrB.Surgicalanatomyoftheearandtemporalbone.New York,NY:ThiemeMedicalpublishers-l11.1989 18.TsehbilscherM,KlugC.TwoF?portendoscopyofthemiddle ear.endowopyanatomy.ArchOolaryngolHead&NeckSurg,1999, 125:433-437 19_???????l?4?X?l??F???_Ff?kX?????????_FP?k?K?????L ??,2002,16:17F?18 20.TakahashiH,Honjo1,FujitsA,Ital.Tn,-tymp,micend-pie findingsmpatientswithotitismediawitheffusion.ArchOtolaryngol Head&NeckSurg,1990,116:1186F?1189 21???????l???????l??&4&??kX?????????Fa???!???D?:?? ??Ff?k??%&?FP???5???O???????????????L??,2002,10:107F? 108 22.M,KetmanKX.Endoseepic"secondlook"masmidoseopyto mieoutresidualepitympaoic/mastoidcholosteatoma.laryngoscope, 1993.103:810F?814 23.RosenbergSLSil_minH,HofferM,etal.Useofendoscopes forchronicearsurgery.ArchOolmyngolHeadandNeckSurg,1995, 121:870F?872 24.YanagiharaN,GyokSY,etal.PerventionofF?N0rrenceof cholestefomainintactcanal'alltymp"??losty.AmJ.Otol,1998,14: 590F?594 25.FabinyiB,KlugG.Aminimallyinvasivetechniquefor-do- ...picmiddleearsurgery.EurArchOlnrhinolaryngol,1997(Suppl),1: 53F?54 26.PusDS,RebsizEE,PankratovMM.Evaluationofperilymphat- isfistulasbymiddleearendompy.Am.J-Owl,1992,13:529F?533 27.OgawaK,KanazakiJ.Ogawa5,etal.Endoscopicdiagnosis47 idiopathicperilymphaticfistula.ActsOtolaryngol,1994(suppl),14: 63F?65 28?????F?lF????l?Z???p?l?b.?kX???FaFn?g???????????? ?P????????????????X????VFP???k?K?????L???l2002,16:338- 339 29.PoeDS.LaserF?assistedendoscopicstepedotomy:apros- peativestudy.Larymgescope,2000,110supp195:1F?37 30.?n??.X?????Fa???s?u???H?V.????????.??????FK?9 ?H?V?h??Fv?s?9?1?5???k?K????F??P???9?????i??:???????V X??Z?Y2000:344F?348 31.ElF?Carson,HF,BedrF?ElF?DineM,TulantAMetalEn- doscopyasatoolinminimallyinvasivetrigeminalnsum?Ctosurgery.0- toF?Neurmol,2002,23:132F?135 32.BedrF?ElF?DineM,ElF?Care.HF,Want End.-pi-flyassisted sionofhernifacielspasm. 33.MckennanKR Inghearingconservation 259F?262 minimallyinvasivemrerovaeeular OrelF?Neurmol,2002,23 Endoscopyoftheinternal122audi AM,stal dooompres- 128 tory acoustictumorsurgery.AmIOtol canaldun 1993,14 34 doscopy 1193F? WackymPA,KingWA,PoeDS,etal.Adjunotivs duringaucomstic 1201 neummasurge??Leryngu-pe,1use999ofen109