带蒂颞肌瓣填塞在二次乳突根治术中的应用  

Application of pedicle temporal muscle flap in the treatment of secondary radical mastectomy

作　　者：李东方[1] 

机构地区：[1]安丘市人民医院耳鼻咽喉科,山东安丘262199

出　　处：《山东大学耳鼻喉眼学报》2015年第6期13-16,21,共5页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：山东省潍坊市卫生局科研项目计划(2013027)

摘　　要：目的探讨耳后带蒂筋膜-颞肌瓣在二次开放式乳突根治术中乳突腔填塞的临床应用。方法对开放式乳突根治术后长期渗液不干耳患者20例(20耳),行二次开放式乳突根治术。行开放式乳突根治术(RM)10例,行开放式乳突根治术伴乳突填塞术(CWDM)10例。CWDM均采用耳后带蒂筋膜-颞肌瓣乳突腔填塞。结果术后均随访2年,RM干耳时间平均(58.4±4.45)d,复诊次数平均(17.1±2.33)次,持续不干耳1例。CWDM干耳时间平均(29.6±2.37)d,复诊次数平均(6.1±1.52)次,无不干耳及术后复发。两组比较,CWDM干耳时间短、复诊次数少(P<0.001)。结论 CWDM干耳时间、复诊次数、术后复发等指标均优于RM,采用带蒂筋膜-颞肌瓣乳突腔填塞效果良好。Objective To explore the clinical application of mastoid cavity packing by retroauricular pedicle fascia-tem-poralis muscle flap in secondary open radical mastoidectomy.Methods A total of 20 patients （20 ears）who had undergone open radical mastoidectomy received secondary open radical mastoidectomy due to long-time wet seepage of their ears.Of them,10 received open radical mastoidectomy （RM）and 10 received open radical mastoidectomy with mastoid packing operation （CWDM）.All CWDM operations adopted retroauricular pedicle fascia-temporalis muscle flap mastoid cavity packing.Results All cases were followed up for 2 years.The average time of ear drying was （58.4 ±4.45）d and （29.6 ±2.37）d in RM group and CWDM group,respectively.The average return visit frequency was （17.1 ±2.33）and （6.1 ±1.52）times in RM group and CWDM group,respectively.One case in the RM group had wet ear continuously.There was no wet ear and relapsing after operation in the CWDM group.CWDM group had a shorter ear drying time and lower return visit frequency than the RM group （P 〈0.001）.Conclusion CWDM is su-perior to RM in ear drying time,return visit frequency and relapsing after operation and other indicators.The mastoid cavity packing by retroauricular pedicle fascia-temporalis muscle flap has a good effect.

关 键 词：筋膜-颞肌瓣 乳突根治 二次手术 填塞 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]