52例先天性耳前瘘管二次手术治疗体会

Clinical analysis of the second operational resection in 52 cases of congenit preauricular fistula

目的:探讨先天性耳前瘘管切除术后复发的原因及再次手术的临床效果。方法:回顾性分析52例先天性耳前瘘管术后再发患者的临床资料,分析引起术后复发的原因,并对二次手术的临床效果进行统计。结果:52例患者中,27例术中可见耳轮脚前方瘘管组织残留,16例可见瘘管组织与耳轮脚软骨粘连,3例沿耳轮脚向上瘘管残余,6例残余瘘管组织伸向外耳道前下壁。50例Ⅰ期痊愈(96.15%)。结论:先天性耳前瘘管切除术后复发的原因主要为瘘管分支走形复杂导致瘘管组织残余、软骨附着等。再次手术彻底切除瘘管组织是治疗先天性耳前瘘管术后复发的有效途径。

Objective：To investigate the causes of postoperative recurrence of congenital preauricu-lar fistula and the clinical effects of the second operational resection .Methods：the clinical data of 52 cases congenital preauricular fistula with postoperative recurrence were retrospectively analyzed . The causes of postoperative recurrence and the clinical effects of the second operational resection were investigated .Results：There are 23 cases with residual fistula organization in front of the crus of helix, 16 cases with residual fistula organization adhered with anthelix cartilage , 3 cases with re-sidual fistula organization above the crus of helix , 6 cases with residual fistula organization toward the anterior-inferior wall of external auditory canal .There were 50 cases with healing by first inten-tion（96.15%）.Conclusion：The main causes of postoperative recurrence of congenital preauricu-lar fistula are the complex fistula fistula branch leading to organization residual , cartilage attach-ment and so on.The second operational resection is an effective method for recrudescent congenital preauricular fistula .