先天性耳前瘘管的走行观察与手术治疗  

Tracts of Congenital Preauricular Fistula and Surgical Treatment

作　　者：王栋 罗五根[1] WANG Dong;LUO Wugen(Department of Otorhinolaryngology Head and Neck Surgery,First Affiliated Hospital of Nanchang University,Nanchang 330006,China.)

机构地区：[1]南昌大学第一附属医院耳鼻咽喉头颈外科,南昌330006

出　　处：《中华耳科学杂志》2020年第4期740-743,共4页Chinese Journal of Otology

摘　　要：目的探讨先天性耳前瘘管的自然瘘口位置与走行关系及手术方式选择。方法回顾性分析南昌大学第一附属医院2013年9月-2019年2月采用手术治疗的159例先天性耳前瘘管患者的临床资料,分析耳前瘘管走行,探讨不同走行的耳前瘘管手术方式的选择。结果159例患者中,125例自然瘘口位于耳轮脚前方,瘘管紧贴耳轮软骨膜,向后下走行至耳前切迹。31例自然瘘口位于耳轮脚,瘘管多穿过耳轮软骨至其深面。3例自然瘘口位于外耳道,瘘管紧贴耳屏软骨向前上走行于耳屏软骨与耳轮软骨之间。术后切口甲级愈合157例,2例术后切口感染,经换药后切口愈合,术后随访5月-5年,无复发。结论先天性耳前瘘管自然瘘口位置与瘘管走行关系密切,术前可根据耳前瘘管自然瘘口位置预判瘘管大致走行,指导手术治疗,能更快速、彻底切除瘘管组织,降低术后复发率,具有一定临床应用价值。Objective To describ the relationship between the natural orifice of preauricular fistula and location of its tracts and the choice of surgical methods.Method Clinical data of 159 patients with surgically treated congenital preauricular fistula from September 2013 to February 2019 were reviewed.Anatomic location of congenital preauricular fistula tract and selection of operative methods were particularly noted and analyzed.Results In 125 of the 159 patients,the natural fistula orifice was located in front of the crus helicis,with the fistula running next to the cartilage down to the intertragic notch.In 31 cases,the orifice fistula was located at the crus helicis,with the fistula mostly passing through the cartilage.In 3 cases,the orifice was located in the external acoustic mestus,with the fistula running anteriorly and superiorly next to between the tragus cartilage and crus helicis cartilage and next to the tragus cartilage.Postoperative wound healing was grade A in 157 cases.Would infection occurred in 2 cases,which resolved after dressing changes.No recurrence was found during the 5 months to 5 years follow-up.Conclusion The location of natural orifice in congenital preauricular fistula is closely related to its anatomic course and can be used to guide surgical treatment,so as to achieve quick and complete removal of the fistula and reduce postoperative recurrence,which is of certain clinical value.

关 键 词：先天性耳前瘘管 手术 

分 类 号：R764[医药卫生—耳鼻咽喉科]