自体延长乳突肌骨膜瓣及骨粉在乳突切除术后修复中应用的长期观察  

Long Term Outcomes of Mastoidectomy Repair with Autologous Extended Mastoid Musculoperiosteal Flap and Bone Powder

作　　者：李嘉[1] 黎雄文[1] 邓晔[1] 林晨希 LI Jia;LI Xiongwen;DENG Ye;LIN Chenxi(Department of Otolaryngology,Meizhou People's Hospital,Meizhou,Guangdong 514031,China)

机构地区：[1]梅州市人民医院耳鼻咽喉科,梅州514031

出　　处：《中华耳科学杂志》2022年第6期858-862,共5页Chinese Journal of Otology

基　　金：2015年度梅州市市级医研类科技计划项目2015B014。

摘　　要：目的探讨自体延长乳突肌骨膜瓣及自体骨粉在乳突切除术后修复中的应用价值及操作要点。方法回顾性分析2016年3月至2020年6月间我科完成的243例(243耳)采用蒂部在乳突尖区的自体延长乳突肌骨膜瓣及自体骨粉进行乳突切除术腔修复的开放式乳突根治术患者的临床资料。结果术后随访14.2±3.4月。术后乳突术腔干耳率为100%(243/243),手术后术腔无分泌物流出的时间平均30.6±7.3天。术区上皮化的时间平均38.2±5.4天。自洁功能恢复好,术腔上皮化后无需定期清理耳道痂皮,术腔钝圆,远期疗效稳定。结论在开放式乳突根治术中,应用自体延长乳突肌骨膜瓣及骨粉进行乳突切除术后修复,可以获得良好的骨面保护、干耳效果,并恢复自洁功能。Objective To report outcomes of mastoidectomy repair with autologous extended mastoid musculoperiosteal flap and bone powder regarding its values and timing.Methods Clinical data of 243 patients(243 ears)who underwent open radical mastoidectomy followed by repair with autologous extended mastoid musculoperiosteal flap pedicled at the tip of mastoid process and bone powder from March 2016 to June 2020 were analyzed retrospectively.Results The mean follow up was 14.2±3.4 months.The rate of dry ear after operation was 100%(243/243).The average time to dry ear was 30.6±7.3 days and the average time to operational cavity epithelization was 38.2±5.4 days.Selfcleaning was well maintained with no need for regular ear canal cleaning once epithelization of the operational cavity was achieved.The operational cavity appeared shallow,and the long-term therapeutic effect was stable.Conclusion In open radical mastoidectomy,the application of autologous extended mastoid musculoperiosteal flap and bone powder can be used to repair the operational cavity with good bone surface protection to achieve dry ear and self-cleaning function.

关 键 词：乳突 耳外科手术 外科皮瓣 自体骨粉 

分 类 号：R764[医药卫生—耳鼻咽喉科]