儿童变异型耳前瘘管临床特征及手术技巧  

Clinical Features of Variant Preauricular Fistula in Children and Surgical Techniques

作　　者：马玉强 刘海霞[1] 王勤学[1] 於清[1] MA Yuqiang;LIU Haixia;WANG Qinxue;YU Qing(Department of otolaryngology,Children's Hospital of Shanxi Province 030013)

机构地区：[1]山西省儿童医院耳鼻咽喉科,太原030013

出　　处：《中华耳科学杂志》2020年第6期1130-1133,共4页Chinese Journal of Otology

摘　　要：目的总结儿童变异型耳前瘘管的临床特点,提高诊断、治疗水平,避免误诊及漏诊的发生。方法回顾性分析山西省儿童医院耳鼻咽喉科2013年7月-2019年3月收治的326例先天性耳前瘘管,其中符合变异型耳前瘘管13例(15耳),对其临床特征,感染史,手术技巧,预后等进行综合分析。结果瘘管开口位于耳轮脚3耳,耳甲腔2耳,耳甲艇1耳,对耳屏2耳,耳轮游离缘2耳;耳轮脚及耳轮脚前双瘘口3耳,对耳屏及耳廓背面双瘘口1耳,耳甲艇及耳轮脚双瘘口1耳。12例(13耳)有感染病史,手术切除,术后均为Ⅰ期甲级愈合,随访1年,均无复发。结论耳前瘘管口常位于耳轮脚前,少数开口于耳轮的后上边缘、耳廓或耳垂等其他部位称之为变异型耳前瘘管。变异型耳前瘘管瘘口通常隐蔽,术前仔细查体,术中完整切除是避免漏诊、误诊及术后复发的关键。Objective To report clinical manifestations variant preauricular fistula in children to improve their diagnosis and treatment.Methods Data from 326 cases of congenital preauricular fistula treated from July 2013 to March 2019 were retrospectively analyzed.Of them,13(15 ears)were diagnosed with variant preauricular fistula.Their clinical manifestations,history of infection,surgical techniques and treatment outcomes were comprehensively analyzed.Results Fistula pits were located in the ascending helix crus(3 ears),cavum conchae(2 ears),cymba conchae(1 ear),antitragus(2 ears),free edge of helix(2ears),ascending helix crus and anterior limb of the ascending helix(3 ears),antitragus and retroauricular area(1 ear),and cymba conchae and ascending helix crus(1 ear).Of the 12 cases(13 ears)with history of sinus infection,classⅠ-a healing was achieved after fistula resection with no recurrence during one year followed up.Conclusions Preauricular fistulas mainly exist on the anterior aspect of the anterior limb of the ascending helix,although some can be located in unusual areas around the auricle,We named these cases as the variant type of preauricular fistula,which is usually concealed.Comprehensive physical examination before surgery and complete lesion removal during surgery are the keys to avoid misdiagnosis and postoperative recurrence.

关 键 词：儿童 先天性耳前瘘管 变异型 诊断 手术切除 

分 类 号：R764[医药卫生—耳鼻咽喉科]