曲安奈德局部注射治疗瘢痕性外耳道狭窄的疗效观察  

Therapeutic effect of local triamcinolone acetonide injection on external auditory canal stenosis induced by scar hyperplasia

作　　者：陈颖 谢友舟 李辰龙 傅窈窈 何爱娟 刘宁华 朱雅颖 张天宇 CHEN Ying;XIE Youzhou;LI Chenlong;FU Yaoyao;HE Aijuan;LIU Ninghua;ZHU Yaying;ZHANG Tianyu(ENT Institute,Department of Facial Plastic and Reconstructive Surgery,Eye&ENT Hospital,Fudan University,NHC Key Laboratory of Hearing Medicine(Fudan University),Shanghai 200031,China)

机构地区：[1]复旦大学附属眼耳鼻喉科医院耳鼻喉科研究院眼耳鼻整形外科,国家卫生健康委员会听觉医学重点实验室(复旦大学),上海200031

出　　处：《中国眼耳鼻喉科杂志》2022年第4期363-365,370,共4页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：上海市科学技术委员会“科技创新行动计划”自然科学基金项目(20ZR1409900);上海市科学技术委员会“科技创新行动计划”技术标准项目(21DZ2200700)。

摘　　要：目的探讨曲安奈德局部注射治疗瘢痕性外耳道狭窄的疗效及并发症。方法本研究为自身对照前瞻性研究。入组就诊于我院的外耳道成形术后瘢痕性再狭窄患者14例,其中1例为双侧,累及外耳道口8例,累及外耳道内7例。取得知情同意后,在外耳道狭窄部位多点注射曲安奈德,注射间隔为1个月,注射后行外耳道软性填塞。定期随访观察外耳道变化,对疗效及并发症进行分析。结果平均注射(3.93±1.67)次,平均随访(5.15±2.92)个月。11例瘢痕性外耳道狭窄得到有效改善,3例在随访中出现再狭窄,再次治疗后可改善;4例狭窄程度无改善。并发症包括注射后舌体麻木1例、恶心呕吐2例、外耳道皮肤坏死1例及糜烂渗出1例,均可自行缓解。结论曲安奈德局部注射治疗瘢痕性外耳道狭窄安全、有效。Objective To investigate the efficacy and complications of triamcinolone acetonide injection in the treatment of external auditory canal stenosis resulting from scar hyperplasia.Methods This was a self-controlled prospective study.A total of 14 patients with postoperative external auditory canal stenosis were enrolled in this study in which one case was bilaterally affected.The lesions were located in the opening of the external meatus in 8 cases,and within the external meatus in the remaining 7 cases.After informed consent was obtained,triamcinolone acetonide was injected in the stenosis of the external auditory canal every month,followed by external auditory canal packing with cotton ball.In the follow-up period,the changes of external auditory canal and adverse events were observed and documented.The efficacy and complications were analyzed.Results Patients were treated for 3.93±1.67 times and were followed up for 5.15±2.92 months.Stenosis in 11 cases were effectively alleviated,and restenosis occurred in 3 cases during follow-up period,which could be improved after re-treatment.Stenosis was not relieved in 4 cases.The complications included numbness in the tongue in one case,nausea and vomiting in two cases,skin necrosis of external auditory canal in one case,erosion and exudation in one case,all of which were relieved without medical intervention.Conclusions Topical injection of triamcinolone acetonide for treating auditory canal stenosis resulting from scar hyperplasia is effective with a few side effects.

关 键 词：外耳道狭窄 外耳道 瘢痕 糖皮质激素 

分 类 号：R764.91[医药卫生—耳鼻咽喉科]