耳廓再造及听力重建同期手术在小耳畸形治疗中的分析

The analysis of simultaneous auricle reconstruction and auditory rehabilitation in treatment of microtia

目的:探讨先天性小耳畸形的诊断及手术方法,分析并总结其临床特点及手术治疗中及术后存在的一些问题。方法:回顾性分析我科2000年1月～2010年1月中手术治疗先天性小耳畸形患者30例(36耳),22耳行自体肋软骨耳廓再造及听力重建术,另5耳只行外耳道、鼓室成形术。结果:就诊患者中听力损失为中度以上及畸形程度较重的占大多数,对不同程度外耳道、中耳畸形内语频听阈的差异分析有统计学差异(P<0.05),畸形越重,听力损失越重。术后耳廓支架外露2耳(9.09%),外耳道再次狭窄5耳(18.52%),感音神经性耳聋1耳(3.70%);结论:耳廓再造及听力重建同期进行即可保证美观又可提高听力,术前需进行综合评估、注意手术适应证的选择,注意手术操作细节及术后护理可降低并发症出现。

Objective To investigate the digriosis and operational method of clinical characters and treatments of congenital microtia, to analyze and summarize the clinical characters with other questions in performance of treatment .Methods From 2000-2010 years,30 patients （36 ears） with the congenitar microtia were analyzed retrospectively,22ears have reconstructed auricle by autogenous costal cartilage and have rehabilitated auditory,other 5ears only have rehabilitated auditory. Results most of patients, hearing loss is over mediocre degree and the degree of atresias is very heavy, to analysis the hearing threshold showed significant difference of clinical analysis in deformans degree of EAM with middte ear,and have relationship between two directions. The postoperative complications were framework expose in 2 ears,external auditory canal stenosis in 5 ears, the sensprineural hearing loss in 1 ear, Conclusion there are more advancement of simultaneous ear reconstruction and hearing rehabilitat ion,careful evaluation of the hearing and imageology of congenital deformity of external and middle ear before operation are important,operation to choose the best surgical approach in accordance with the specific conditions of patients is the key to enhance the effectiveness.