耳前组织整块切除术治疗难治性耳前瘘管

摘要

Objective To report a surgical technique for treatment of preauricular fistula for lower recurrence rate and discuss on factors relevant to the prognosis. Method This is a retrospective analysis of clinical data from 187 patients with pre-auricular fistula who underwent en bloc excision from August 2006 to November 2012 at the Affiliated Hospital of Luzhou Medical College. En bloc fistula resection was bounded by the superficial temporalis fascia, helix perichondrium and cra-nio-auricular groove. Results Among the 187 cases, 181 achieved primary intention healing and 6 resulted in secondary inten-tion healing. The follow-up period was from one to seven years. There were 4 recurrences during the follow-up (2.1%). Con-clusions Identifying the scope of surgical resection before surgery can facilitate easy and thorough resection of a preauricular fistula with low recurrence rate. The prognosis depends on proper timing of surgery and successful elimination of hidden fistula branches.%目的：探讨先天性耳前瘘管的手术治疗方式，以降低术后复发率。方法回顾性分析泸州医学院附属医院2006年8月-2012年11月采用以颞筋膜浅层、耳轮软骨膜及颅耳沟皮下为手术界限的耳前组织整块切除治疗的187例先天性耳前瘘管患者的临床资料，并探讨影响预后的相关因素。结果187例患者，切口甲级愈合181例，乙级愈合6例，随访1-7年，4例复发，复发率约2.1%（4/187）。结论确定一个耳前瘘管手术切除的界限对于治疗先天性耳前瘘管具有操作简便、切除彻底、复发率低的优势，有一定的临床应用价值；影响其预后的关键因素是手术时机的选择和潜在病变的寻找。