个体化中空树酯支撑物预防小耳畸形术后外耳道狭窄

摘要

Objective To investigate the application and the effects of individualized hollow resin plugs in the prevention of external auditory canal stenosis after canaloplasty of external auditory meatus for microtia patients . Methods The clinical data of 65 patients (68 ears) with microtia and aural atresia hospitalized in our department from January ,2006 to December ,2015 were summarized .Otoplasty of external ears and canaloplasty of external auditory meatus were operated on all patients under general anesthesia .Thigh flap transplantation was lined in the bony canal .One month later ,individualized hollow resin plugs were made and worn for 6 to 12 months ,and fol-lowed up for 1～2 years .Results The shapes of the reconstructed auricles were satisfactory .Sixty-four ears with wide external auditory canal openings were recorded in 68 ears .Preoperative hearing was 70 .45 ± 5 .5 dB HL ,and postoperative hearing was 55 .55 ± 5 .2 dB HL .Their hearing was not affected .External auditory canal restenosis occurred in 4 ears .Conclusion The individualized hollow resin plugs do not affect the hearing in use ,and can effec-tively prevent the restenosis of the external auditory canal after microtia reconstruction .%目的 探讨个体化的中空树酯支撑物在预防小耳畸形术后外耳道狭窄中的应用及效果.方法 回顾性分析2006年1月～2015年12月行手术治疗的65例(68耳)先天性小耳畸形并外耳道闭锁患者的临床资料,所有患者均在全麻下行同期耳廓成形并外耳道重建术,其中42例同时完成了听骨链重建术;所有患者在重建的外耳道内行大腿内侧皮瓣移植,术后1个月左右佩戴用印模技术制作的中空树酯支撑物6个月～1年,并随访1～2年,观察外耳道口及外耳道有无狭窄、感染及听力情况.结果 68耳耳廓外形满意,68耳中有64耳外耳道口宽敞,未再发生外耳道狭窄或闭锁,4耳外耳道再次狭窄;术前0.5、1、2kHz平均气导听阈为70.45±5.5dBHL,术后为55.55±5.2dBHL.在听力提高的患者中,患者听力未因佩戴支撑物受影响.结论 在先天性小耳畸形患者行外耳道成形术后应用个体化中空树酯支撑物可有效预防外耳道再次狭窄或闭锁,且佩戴过程中不影响听力.