三瓣法鼓室成形术的临床研究

Result of tympanoplasty with three flaps-Report of 113 eArs

目的：探讨三瓣法制备移植床对鼓膜成形术的影响。方法：对慢性化脓性中耳炎患者行鼓室成形术１０４例（１１３耳）。耳后上切口，将蒂在外侧的耳道后壁皮瓣固定于耳廓。垂直于鼓环在外耳道后下、前下及前上纵形切开，将外耳道皮肤连同相应残余鼓膜及鼓环掀起，即形成蒂在外方的前、下两个外耳道皮瓣，及蒂在上方的后壁小皮瓣。结果：经１年以上随访，移植物均成活。结论：耳后上切口三瓣法制备移植床视野宽大清晰，血供丰富，确保了移植物的成活。

Objective:To investigate the effect of tympanoplasty with three flaps.Method:One hundred and four patients(48 males and 56 females,ranging in age from 12 to 69 years old) with chronic otitis media(113 ears)were undergoing tympanoplasty.The procedure of tympanoplasty was followed:With postsuperion of the auricle,the skin was cut postinferiorly,ant eroinferiorly and anterosuperiorly respectively.The three cuts vertical to the tympanic annulus.Then the flaps with corresponding tympanic annulus were elevated with their external peduncles.As a result ,three flaps were formed with their peduncles anteriorly,inferiorly and superiorly respectively.Result :With more that one year′s follow-up ,all the grafts were survival and all the per farations were cured .Conclusion:Approaching with postsuperior incision of the a uricle ,the three flaps have a large working room and field.Using the three flaps with their aboundant vascularity shuold be a high rate of success in tympanoplasty. [Chinese Arch Otolaryngol Head Neck Surg,2002;9(1):7～9 From the Department of Otolaryngology,First Hospital of Xinxiang,Henan Xinxiang 453000(Dr.Sun Zhiqiang)]