先天性耳畸形的手术治疗(附24例报告)

Surgery of Congenital Ear Deformities(24 cases report)

目的 探讨治疗先天性耳畸形的不同手术方式及疗效,评估同期行耳廓成形及听力重建术的可行性。方法 回顾性分析1985～2 0 0 3年本科收治的2 4例( 2 4耳)先天性耳畸形的患者,分别为单纯外耳道成形术6耳,外耳道-鼓室成形术10耳,同期行耳廓耳道成形及鼓室成形术8耳。结果 行听力重建术的18耳,术后1个月纯音测听言语频率平均气骨导差缩小10～30dB ;外耳道成形2 4耳中,5耳耳道狭窄;耳廓再造8耳均成活,近期耳轮、对耳轮出现,但远期效果较差,耳廓有不同程度的缩小变形。结论 外耳道成形及听力重建术是治疗先天性耳畸形有效的手段,而同期行耳廓成形是可行的;以扩张后的薄皮瓣行耳廓成形效果较好。

Objective To investigate the effect of otoplasty and elevate the possibility of same stage otoplasty for congenital atresia of external acoustic canal and malformations of middle ear and the auricle.Methods 24 patients with congenital aural malformation were operated on aural canal reconstruction(6 ears ),aural canal reconstruction and tympanoplasty(10 ears) and surgical reconstruction of same stage otoplasty(8 ears).Results 1 month after operation,15～30 dB improving of the pure-tone threshold was shown in 18 ears, and canal restenosis was shown in 5 ears.In 8 ears of same stage otoplasty,the prosthetic auriculae were survival and figuration was ideal.Conclusion Meatoplasty and auditory rehabilitation surgery is effective for congenital aural atresia. Same stage otoplasty is possible for congenital malformations of middle ear and the auricle. The vascularized postauricular skin flap can prevent reatresia of aural canals.