咽鼓管阻塞为鼓室成形术的绝对禁忌症。为恢复咽鼓管功能,手术进路有三:外进路,影响颞颌关节腔;经颅进路,不易处理咽鼓管峡部;经硬腭进路,手术野较远,不易精细操作。作者认为经乳突进路最好。咽鼓管成形术留置扩张管或硅膜,经过数月取出后仍可再次形成狭窄,作者认为只有放置圆柱形自体粘膜或内皮组织才能维持已经扩大的咽鼓管骨及软骨部腔径。操作方法:在耳后沟后方1cm处作耳后上切口,剥离耳郭,沿外耳道切开骨膜,暴露外耳道后上棘和乳突皮质。打开乳突,如乙状窦前移,应将其暴露并牵向后方,避免影响视野。由乳突腔打开鼓室及后鼓室,顺此把外耳道后壁之后下及前上方切断,取下外耳道骨片置于抗生素液体 Eustachian tube obstruction is an absolute contraindication tympanoplasty. To restore Eustachian tube function, there are three surgical approaches: the outer access, affecting the temporomandibular joint cavity; transcranial approach, not easy to deal with Eustachian tube isthmus; the hard palate into the road, the surgical field far, not easy to fine operation. The author believes that the best way through the mastoid. Eustachian tube angioplasty indwelling dilation tube or silicon film, after a few months after removal can still be formed again narrow, the author believes that only placed cylindrical autologous mucosa or endothelial tissue to maintain the enlarged eustachian tube and cartilage cavity diameter. Method of operation: 1cm behind the posterior groove of the ear after the ear incision, stripping the ear Guo, cut along the external auditory canal osseous membrane, exposed after the auditory canal and mastoid cortex. Open the mastoid, such as sigmoid sinus forward, it should be exposed and lead to the rear, to avoid affecting vision. The tympanic cavity is opened by the tympanic cavity and the tympanic cavity, along with the posterior wall of the external auditory meatus, the upper and lower sides of the external auditory meatus are cut off, the external auditory canal bone fragment is removed and placed in the antibiotic liquid