外耳道后壁皮瓣完全游离的耳道皮瓣保护方式在耳内镜胆脂瘤手术中的应用  

Application of ear canal flap protection with completely free posterior wall flap of external auditory canal in endoscopic cholesteatoma surgery

作　　者：金玉波 曾楠 杨琼 JIN Yubo;ZENG Nan;YANG Qiong(Department of Otolaryngology,Huazhong University of Science and Technology Union Shenzhen Hospital(Nanshan Hospital),Shenzhen,Guangdong,518000,China)

机构地区：[1]华中科技大学协和深圳医院(南山医院)耳鼻咽喉科,广东深圳518000

出　　处：《中国耳鼻咽喉头颈外科》2022年第5期297-300,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的 探索全耳内镜胆脂瘤手术持续灌流模式进行水下磨骨时更好保护外耳道皮瓣的方式。方法 调阅2020年6月~2021年9月收治的97例中耳胆脂瘤患者的全程手术视频,将其分为三组,其中32例患者采用锡箔纸压迫保护外耳道皮瓣,40例为骨蜡压迫,25例为外耳道后壁皮瓣完全游离。记录不同方式的手术时间及术后术腔上皮化情况。结果 三组患者术后2个月内完成术腔上皮化率分别为84.4%、82.5%、80%,各组间比较均无统计学差异(P>0.05)。手术用时分别为(3±0.52)h、(3±0.47)h、(2±0.33)h,皮瓣游离组手术用时较其他两组明显缩短,均具有统计学差异(P<0.05),而另两组手术用时组间比较,无统计学差异(P>0.05)。结论 外耳道后壁完全游离的皮瓣保护方式可大幅缩短手术时间,有利于推广。OBJECTIVE To explore a better way to protect external auditory canal flap during underwater bone grinding under continuous irrigation mode in total ear endoscopic cholesteatoma surgery.METHODS The videos of 97 patients with middle ear choladiatoma admitted from June 2020 to September 2021 were reviewed and divided into three groups.Among them,32 patients were protected by tinfoil compression,40 by bone wax compression,and 25 by complete dissociation of external auditory canal posterior wall flap.The operative time and postoperative lumen epithelialization were recorded.RESULTS The rate of intraoperative lumen epithelialization in the three groups within 2 months after surgery was 84.4%,82.5% and 80% respectively,and there was no statistical difference among the three groups(P>0.05).The average operation time was (3±0.52)h,(3±0.47)h and (2±0.33)h,respectively.The operation time of the free flap group was significantly shorter than that of the other two groups,with statistical differences(P<0.05),while there was no statistical difference between the other two groups(P>0.05).CONCLUSIONThe flap protection mode of completely free posterior wall of external auditory canal can greatly shorten the operation time and is beneficial to popularization.

关 键 词：外科皮瓣 灌流 内窥镜检查 胆脂瘤 中耳 水下磨骨 耳内镜 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]