自体骨粉和颞肌筋膜在中耳乳突手术中的应用  

Application of Autologous Bone Meal and Temporalis Fascia in Middle Ear and Mastoid Surgery

作　　者：陈燕红 罗五根[2] 游鸿 江红群[2] 张志远[2] 

机构地区：[1]新余市人民医院耳鼻咽喉头颈外科,江西新余338025 [2]南昌大学第一附属医院耳鼻咽喉头颈外科,南昌330006

出　　处：《南昌大学学报（医学版）》2013年第9期15-17,37,共4页Journal of Nanchang University：Medical Sciences

基　　金：江西省卫生厅科技计划(20121054);江西省新余市科技计划(20123090823)

摘　　要：目的探讨自体骨粉和颞肌筋膜在乳突根治鼓室成形术后乳突腔填充的临床疗效。方法对2009年7月至2011年10月间经1年以上随访的350例(耳)乳突根治鼓室成形术同时以自体乳突皮质骨粉行乳突填充及颞肌筋膜覆盖、重建外耳道后壁耳道成形的病例进行回顾性分析。结果乳突填充自体骨粉并用颞肌筋膜叠瓦状覆盖,术后外耳道形态良好,耳道宽敞平滑,愈合时间显著缩短,术后干耳率高、复发率低。结论自体乳突皮质骨粉在上鼓室及乳突区病灶清除后的处理中是良好的填充材料,颞肌筋膜覆盖可防止骨粉脱落,两者结合有利于术后早期干耳。Objective To explore the clinical efficacy of autologous bone meal and temporalis fascia in mastoid obliteration after tympanoplasty with radical mastoidectomy. Methods Data of 350 patients who underwent mastoid obliteration with autologous bone meal and imbricate cover age with temporalis fascia and were followed up for more than 1 year between July 2009 and October 2011 were retrospectively analyzed. The operating procedures included the canal wall down mastoidectomy with tympanoplasty and intact-bridge mastoidectomy with tympanoplasty. Results Mastoid obliteration with autologous bone meal and imbricate coverage with temporalis fascia resulted in excellent external auditory canal shape, spacious and smooth auditory meatus, short healing time,high dry ear rate and low recurrence rate. Conclusion Autogenous mastoid cortical bone meal is an excellent filler material for the debridement treatment of the attic and mastoid area. Coverage with temporalis fascia prevents bone meal loss. The combination of bone meal and temporalis fascia is propitious to the early postoperative ear dry.

关 键 词：乳突根治鼓室成形术 自体骨粉 颞肌筋膜 叠瓦法 外耳道后壁重建 

分 类 号：R764.92[医药卫生—耳鼻咽喉科]