摘要
目的探讨鼓窦径路治疗先天性外耳道闭锁中耳畸形的效果及重建耳道再闭锁的预防方法。方法回顾性分析我科2000～2008年8年间收治的接受手术治疗、并获随访且资料完整的先天性外耳道闭锁中耳畸形病人48例(54耳),所有病人均采用鼓窦径路重建外耳道,鼓室成形术,其中Ⅱ型45耳、Ⅲ型9耳,术后随访18个月以上。结果54耳均顺利找到鼓窦,开放鼓室行听力重建,全部病例均伴有不同程度的耳廓和听骨链畸形,听骨链畸形最多见于锤、砧骨(40耳),其次为镫骨上结构(12耳),伴面神经畸形者占23耳。术后1年语言频率平均听力提高20dB以上者45耳(83.3%),提高25dB以上者25耳(46.2%)。结论鼓窦径路治疗先天性外耳道闭锁具有易掌握、安全、效果可靠等特点,保持术后重建外耳道的宽度及防止鼓膜外侧愈合是提高先天性外耳道闭锁术后远期疗效的关键。
Objective To assess the effect of surgical reconstruction of congenital aural atresia via the mastoid antrum approach and investigate method for preventing postoperative atresia of the reconstructed aural canal. Methods From 2000 to 2008, aural canal reconstruction and tympanoplasty was performed via the mastoid antrum approach. In 48 patients with congenital aural atresia （54 ears, including 45 ears of type II, 9 ears of type III）. All the patients were followed-up for 18 months to assess the therapeutic effect. Results The mastoid antrum was located uneventfully for all the 54 ears, all showing ossicular chain anomalies involving most frequently the malleus and the incus followed by the upper structures of the stapes. Facial nerve abnormalities were seen in 23 ears （42,6%）. Heating improvement to over 20 dB was achieved in 45 ears （83.3%） and to over 25 dB in 25 ears （46.2%） one year later. Conclusion The mastoid antrum approach for surgical reconstruction of congenital aural atresia is safe and reliable. Maintenance of the width of the aural canal and prevention of lateral healing of the transplanted tympanic membrane are crucial in the treatment of congenital aural atresia.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2009年第5期1057-1059,共3页
Journal of Southern Medical University
关键词
畸形
外耳
中耳
鼓窦
abnormalities
external ear
middle ear
mastoid antrum
