软壁外耳道重建的鼓室成形术  

Tympanoplasty with soft-wall reconstruction of ear canal

作　　者：孙开[1,2] 管国芳[1] 金春顺[1] 刘瑶[1] 张德军[1] 郝延茹[1] 娄玮[1] 史平[1] 孙丽丽[1] 

机构地区：[1]吉林大学第二医院耳鼻咽喉头颈外科,长春130041 [2]吉林市人民医院耳鼻咽喉头颈外科,吉林132001

出　　处：《临床耳鼻咽喉头颈外科杂志》2011年第16期744-746,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:观察软壁外耳道重建的鼓室成形术治疗胆脂瘤中耳炎的疗效。方法:73例(76耳)胆脂瘤中耳炎患者行开放式乳突病变切除鼓室成形术,以耳后肌骨膜瓣行软壁外耳道重建,不做耳甲腔成形术,应用自体乳突皮质骨或砧骨雕刻后行听骨链重建。观察术后外耳道的形态和功能、术后听力以及有无并发症。结果:本组平均干耳时间为术后(21.1±3.1)d。术后外耳道形态基本正常,保持了正常的功能。随访6～24个月,术后气导听力平均改善(14.5±6.1)dB HL。结论:应用耳后肌骨膜瓣行软壁外耳道重建的鼓室成形术能使外耳道的形态和功能基本恢复正常,无需行耳甲腔成形术,听力改善满意。Objective：To observe the therapeutic effect of tympanoplasty with soft-wall reconstruction of ear canal for chronic otitis media with cholesteatoma.Method：Seventy-three patients（76 ears） suffering from chronic otitis media with cholesteatoma were treated with canal wall down mastoidectomy with tympanoplasty.Postauricular myo-periosteal flap was used to the soft-wall reconstruction of ear canal,and the cavityplasty of auricular concha was not performed.The auricular bone prosthesis was made of the autogeneic mastoid cortical bone or residual incus.The postoperative modality and the function of external auditory canal and the postoperative hearing and the postoperative complications were observed.Result：The mean dry ear time was（21.1±3.1） days after surgery in this study.The postoperative modality of external auditory canal was normal on the whole.The patients were followed up between 6 months and 24 months after surgery.The postoperative average air conduction hearing was improved by（14.5±6.1）dB HL.Conclusion：Tympanoplasty with soft-wall reconstruction of ear canal using the postauricular myo-periosteal flap can recover the modality and function of external auditory canal on the whole,and the cavityplasty of auricular concha is not needed.The postoperative hearing can be improved by this technique satisfactorily.

关 键 词：软壁 外耳道 鼓室成形术 胆脂瘤 中耳 

分 类 号：R764.2[医药卫生—耳鼻咽喉科]