耳屏软骨加颞肌筋膜在外耳道骨壁及皮肤缺损重建中的应用  

Canal wall reconstruction with tragus cartilage and tempralis fascia graft

作　　者：邵永良[1] 周永青[1] 李晓明[1] 李震[1] 邸斌[1] 陈旭真[1] 

机构地区：[1]白求恩国际和平医院耳鼻咽喉头颈外科,石家庄050082

出　　处：《临床耳鼻咽喉头颈外科杂志》2014年第16期1235-1237,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨耳屏软骨+颞肌筋膜在外耳道骨壁及皮肤缺损重建手术中的应用及治疗效果。方法:41例外耳道病变患者中,39例为外耳道胆脂瘤,2例为外耳道骨瘤。术中出现外耳道骨壁及皮肤缺损,乳突气房暴露,用耳屏软骨+颞肌筋膜对外耳道缺损骨壁及皮肤进行修复,并于术后3周、3个月、6个月和1年进行随访。结果:术后3周时,29例外耳道骨壁及皮肤缺损重建患者1期愈合,12例术区见肉芽生长,刮除肉芽,再次碘仿纱条填塞1周后,创面愈合;3个月时,所有患者外耳道术区上皮化,无外耳道狭窄发生;术后6个月、1年复查,外耳道形态正常,无外耳道骨壁塌陷及乳突气房暴露。结论:采用耳屏软骨+颞肌筋膜修复外耳道骨壁及皮肤缺损,取材方便,易于操作;修复的外耳道壁封闭了与外耳道相通的乳突气房;由于软骨的支撑,保持了外耳道的正常形态。This paper highlights the therapeutic effect of tragus cartilage and temporalis fascia graft on repairing bone and skin defect in external auditory canal. Method：Forty-one surgical patients were recuited, in- cluding 39 cases of external auditory canal cholesteatoma and 2 cases of osteoma. External auditory canal bone wall and skin defect and mastoid air cells exposure were found during operation. We followed up these cases periodical- ly （in 3 weeks, 3 months, 6 months and 1 year later respectively） after repairing the patients external auditory ca- nal bone wall and skin with tragus cartilage and temporalis fascia graft. Result： Twenty-nine cases healed perfectly while other 12 cases grew small granulation in 3 weeks. After shaving granulations and tamping Tela Iodoformum, wounds healed in the following week. The epithelization of the external auditory canal in our patients was complete after 3 months and no stenosis were found. Natural morphology of external auditory canal was maintained without mastoid air cells exposure after 6 months to 1 year of time. Conclusion：It is not only convenient to acquire the tra- gus cartilage and temporalis fascia, but also easy to repair the defect of external auditory canal bone wall and skin. It can reconstruct the wall of external auditory canal, obliterate mastoid cells and perfectly maintain the normal form of external auditory canal via the cartilage.

关 键 词：外耳道 耳屏软骨 颞肌筋膜 修复外科手术 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]