外耳道成形术:外科技术与效果分析  

Canalplasty:surgical technique and analysis of the results

作　　者：魏兴梅 张秀菊[2] 孙慧颖 田旭[1] 赵杨[1] 高志强[1] 冯国栋 WEI Xingmei;ZHANG Xiuju;SUN Huiying;TIAN Xu;ZHAO Yang;GAO Zhiqiang;FENG Guodong(Department of Otorhinolaryngology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,100730,China;Department of Otorhinolaryngology,Aerospace Center Hospital)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院耳鼻咽喉科,北京100730 [2]航天中心医院耳鼻咽喉科

出　　处：《临床耳鼻咽喉头颈外科杂志》2019年第7期654-657,661,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：“十二五”国家科技支撑计划重点项目(No:2012BAI12B01);北京市自然科学基金(No:7182133)

摘　　要：目的:探讨外耳道成形术在中耳手术中的应用及效果。方法:以2012-2016年因中耳病变行外耳道成形加完壁式中耳手术的72例(74耳)患者为研究对象。回顾性分析患者的一般情况、疾病类型、手术方式、术后干耳时间、并发症及术后听力恢复情况。结果:慢性化脓性中耳炎48耳,中耳胆脂瘤12耳,鼓室硬化症7耳,中耳胆固醇肉芽肿5耳,粘连性中耳炎2耳。术中探查锤骨前韧带存在病变者16耳(21.6%),术后69耳(93.2%)完全上皮化,上皮化的平均时间为5.3周;72耳(97.3%)鼓膜穿孔修补成功;5耳(6.8%)发生外耳道成形相关并发症。术后1年平均气骨导差缩小8dB,较术前显著改善(P<0.05)。结论:外耳道成形术安全稳定,术中可较好地暴露鼓膜整体情况、充分探查鼓室内容。术后上皮化概率高,对于提高鼓膜修补成功率和改善患者听力提供了良好的操作条件。Objective:To determine the applications and results of canalplasty for closed middle ear surgery.Method:Charts of 74 ears who underwent a canalplasty and closed middle ear surgery because of chronic otitis media or middle ear cholesterol granuloma between 2012 and 2016 were reviewed for general condition,disease,surgery methods,surgical outcome,complications,results of pure tone audiometry pre-and post-operatively.Result:Sixteen(21.6%)ears have some problems of their anterior ligament of malleus.Post-operative there are 69 ears totally epithelization,of which the rate is 93.2%,and the average epithelization time is 5.3 weeks.The myringoplasties are successful on 72 ears(97.3%).There are 5 ears(6.8%)occurring complications relating to canalplasty.One year after surgery the air-bone gap has decreased by 8 dB,which has been improved significantly than pre-operative(P<0.05).Conclusion:This study shows that technique for canalplasty is safe and effective,which can exposure the whole tympanic membrane and is easy for tympanoplasty.The epithelization rate of our technique is high.And it's good for myringoplasty and hearing outcomes.

关 键 词：外耳道成形术 完壁式中耳手术 鼓室成形术 上皮化 

分 类 号：R764.92[医药卫生—耳鼻咽喉科]