中耳手术后并发化脓性耳廓软骨膜炎的治疗  

Treatment of Auricular Perichondritis Secondary to Middle Ear Surgeries

作　　者：郑铨艺 柯朝阳 龚桃根 吕颜露 鄢敏 ZHENG Quanyi KE Zhaoyang GONG Taogen LV Yanlu YAN Ming(Department of Otolaryngology, Second Clinical Medical College of Jinan University Shenzhen People＇ s Hospital, Shenzhen 518020, China)

机构地区：[1]暨南大学第二临床医学院(深圳市人民医院)耳鼻咽喉科,深圳518020

出　　处：《中华耳科学杂志》2017年第3期317-320,共4页Chinese Journal of Otology

摘　　要：目的总结中耳手术后并发化脓性耳廓软骨膜炎的治疗经验。方法回顾性分析9例中耳手术后并发化脓性耳廓软骨膜炎患者的临床资料。结果 9例患者均于中耳手术后4-15天(平均7.8天)出现术耳耳廓疼痛,4例耳廓软骨未受累者经抗炎、切开排脓治疗后痊愈,未遗留耳廓畸形;4例部分耳廓软骨受累者经1-2次病变软骨清创术治愈,其中1例遗留轻微耳廓畸形;1例全耳廓软骨受累感染者行彻底软骨清创术后遗留菜花样耳畸形。结论中耳手术后并发化脓性耳廓软骨膜炎早期易忽视、漏诊,炎症早期应以抗绿脓杆菌抗生素为主;一旦脓肿形成,则应及时切开排脓;若软骨受累,则应果断、彻底行病变软骨清创术。Objective To report experiences in the treatment of auricular perichondritis secondary to middle ear surgeries.Methods Clinical data of 9 patients who were admitted for auricular perichondritis after middle ear operation were retrospectively analyzed.Results Auricle soreness usually occurred 4 to 15 days（average 7.8 days） after the middle ear operation.In 4 patients,where the auricular cartilage was not involved,peirchondritis resolved following antibiotics treatment or/and incision and drainage without any deformity.Debridement（one to two times） was performed in 4patients whose auricular cartilage were partly involved,resulting in minor residual deformity in one patient.The remaining one patient whose auricular cartilage was extensively involved was treated by radical surgical debridement and ended up with a＂cauliflower ear＂.Conclusions Auricular perichondritis secondary to middle ear operation is often not diagnosed properly.Initial treatment should include anti-pseudomonal antibiotics.Incision and drainage should be performed in cases in which an abscess has formed.Once the auricular cartilage is involved,prompt and thorough surgical debridement should be performed.

关 键 词：软骨膜炎 耳廓 手术并发症 中耳手术 脓肿 清创术 

分 类 号：R764[医药卫生—耳鼻咽喉科]