自制持续灌流装置在耳内镜上鼓室胆脂瘤手术中的应用  

Clinical application of a self-developed suction-irrigation device in endoscopic ear surgery for attic cholesteatoma

作　　者：李阳[1] 盛颖 王军利[1] 郭立[1] 杨叶叶[1] 李桔林[1] 王婷[1] 吴宝俊[1] 任晓勇[1] Li Yang;Sheng Ying;Wang Junli;Guo Li;Yang Yeye;Li Julin;Wang Ting;Wu Baojun;Ren Xiaoyong(Department of Otolaryngology Head and Neck Surgery,the Second Affiliated Hospital,Xi′an Jiaotong University,Xi′an 710004,China)

机构地区：[1]西安交通大学第二附属医院耳鼻咽喉头颈外科病院,西安710004

出　　处：《中华耳鼻咽喉头颈外科杂志》2022年第11期1319-1322,共4页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：陕西省国际科技合作与交流计划(2020KW-045)。

摘　　要：目的介绍一种简易的耳内镜持续灌流装置的制作, 并观察其在上鼓室胆脂瘤手术中的应用。方法回顾性分析2019年10月至2021年6月在西安交通大学第二附属医院接受持续灌流耳内镜上鼓室胆脂瘤手术的患者38例, 其中男性17例, 女性21例, 年龄(38.6±11.9)岁。测量安装灌流装置后耳内镜的直径、使用该装置的灌流速度和手术的时间, 分析术中术野暴露情况及术后并发症。结果安装自制灌流装置后耳内镜直径为3.5~4.6 mm, 灌流速度可达20~40 ml/min;持续灌流模式下术野清楚, 手术时间为(86.6±18.1)min。3例患者术中出现耳道皮肤损伤。无皮瓣缺血坏死、耳道瘢痕狭窄、感音神经性听力损失、脑脊液漏及面神经麻痹等术后并发症。结论该自制持续灌流装置简单、实用, 为水下耳内镜上鼓室胆脂瘤手术灌流方式提供了一种新选择。Objective To introduce a new self-developed irrigation device(SID)that does not employ a sheath or an irrigation-suction system and evaluate to its efficiency in transcanal endoscopic ear surgery(TEES)for attic cholesteatoma.Methods 38 patients who were subjected to TEES for attic cholesteatoma between October 2019 to June 2021 were included in this study,including 17 males and 21 females with an average age of(38.6±11.9)years.SID and underwater continuous drilling were used during operation.Width of endoscope and irrigation speed were measured when SID was applied.The operating time,surgical view and complications were compared between two groups.Results The width of the endoscope was 3.5-4.6 mm in diameter and the irrigation speed was 20-40 ml/min when SID was used.SID cleaned the lens at the tip of the endoscope and created a clear field of view during TEES.The operation time was(86.6±18.1)min.The skin of the external ear canal was found injured during operation in 3 patients,but there were no complications such as necrosis of the flap,stenosis of external ear canal,sensorineural hearing loss,facial paralysis and cerebrospinal fluid leakage.Conclusions SID is simple and enhances the efficacy of TEES,providing a new irrigation choice in TEES for attic cholesteatoma.

关 键 词：内窥镜 耳外科手术 胆脂瘤 中耳 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]