外耳道后壁骨性重建技术临床应用与疗效观察  

Reconstruction of Posterior EAC Wall with Bone Grafts

作　　者：历东东 唐琦[2] 陈晓巍[2] 高志强[2] 杨华[2] LI Dongdong;TANG Qi;CHEN Xiaowei;GAO Zhiqiang;YANG Hua(Department of Otolaryngology,Karamay Central Hospital,Karamay,Xinjiang;Department of Otolaryngology,Peking Union Medical College Hospital,Beijing)

机构地区：[1]新疆维吾尔自治区克拉玛依市中心医院耳鼻喉科 [2]中国医学科学院北京协和医院耳鼻喉科

出　　处：《中华耳科学杂志》2018年第5期646-650,共5页Chinese Journal of Otology

基　　金："十二五"国家科技支撑计划重点项目(项目编号:2012BAI12B00/2012BAI12B01)~~

摘　　要：目的研究和观察外耳道后壁重建技术临床应用效果。方法收集8例外耳道后壁骨性缺损致外耳道-乳突沟通性病变患者,行完壁式乳突切开术去除乳突病变,部分患者同时行鼓室探查和鼓室成形术,在彻底清除外耳道原发病变基础上,采用乳突骨皮质修复外耳道后壁骨性缺损。结果随访时间平均为37.25月,所有8名患者均一期手术外耳道后壁骨性重建成功,外耳道通畅、后壁完整,乳突及鼓室均未见明显病变,未发现胆脂瘤复发;术前骨导平均听阈为17.19±8.86dBHL,气骨导差(ABG)为35.94±13.82dBHL;术后骨导平均听阈为17.81±8.38dB-HL,ABG为14.06±12.39dBHL。所有患者术后听力均明显提高或恢复至正常。结论经严格选择适应证,外耳道后壁重建技术可以有效地重建外耳道-乳突正常生理分割恢复和保留正常生理功能,远期效果良好。Objective To report results of reconstruction of posterior EAC wall with mastoid cortical bone sheets.Methods Patients with bony posterior EAC wall defects were included in this study and received reconstruction using autologous mastoid cortical bone sheets after mastoidectomy to eradicate primary diseases.Results Reconstruction was successful in all eight patients.During the average 37.25 months follow up,the EAC remained adequately open with the posterior wall intact.All patients gained normal hearing or hearing improvement.No recurrence of primary diseases(such as cholesteatomas)was detected.The average bone conduction threshold was 17.19±8.86 dB HL before surgery and 17.81±8.38 dB HL after surgery;while the mean AB gap before and after surgery was 35.94±13.82 dB and 14.06±12.39 dB,respectively.Conclusion Reconstruction of posterior EAC wall using bone grafts is an effective and useful treatment for bony posterior EAC wall defects in appropriately selected cases.

关 键 词：外耳道后壁重建术 乳突骨皮质 完壁式乳突切开 

分 类 号：R764[医药卫生—耳鼻咽喉科]