防止再造外耳道再闭锁与狭窄的新策略和方法

New Strategies and Methods to Prevent Reatresia/Restenosis of Reconstructed External Auditory Meatus(Re-EAMs)

目的探索先天性外耳道闭锁/狭窄耳道再造术后防止再闭锁/狭窄新的策略与方法。方法根据作者临床观察再造耳道再闭锁/狭窄的特点,提出了一系列新的预防策略和方法,并研究、设计了相关专利产品。包括改善覆盖上皮种类与方法、模拟鼓环功能、加强术后支撑与扩张。结果再狭窄/闭锁发生率在中厚皮片拼接法16.9%(10/59),明显低于替尔氏皮片桶状植皮34%(17/50)(p<0.05)与拼接植皮45.5%(15/33)(p<0.01),而后两者间及其它方法间无明显差异(p>0.05);人工鼓环模拟鼓环功能效果明显;外耳道扩张器与耳道模型支架能起明显的扩张和支撑作用。结论中厚皮片拼接加人工鼓环置入及术后有效的支撑和扩张是防止再造外耳道再狭窄或闭锁新的有效的方法,在临床值得推广应用。

Objective To explore new strategies and methods to prevent re-atresia/restenosis of reconstructed exter？nal auditory meatus （Re-EAMs） for congenital aural atresia/stenosis patients. Methods according to the reatresia/resteno？sis characteristics of Re-EAMs observed by the authors, a series of new prevention strategies, methods and relevant patent products are designed, measures include in improving types and methods of the covering epithelium with all kinds of free skin＆skin flap, simulating function of the tympanic rings and supporting＆expanding Re-EAMs Results the restenosis/reatre？sia rate split for thickness skin graft by mosaic 16.9%（10/59） is significantly lower than those of Thiersch’s skin graft in bar？rel-like 34%（17/50） （p0.05）. The artificial tympanic ring make good effect, and the EAM expandor and EAM model bracket execute the function well. Conclusion It is a new effective method to prevent restenosis/reatresia of the Re-EAMs） by mosaic grafting free thickness skin , implanting artificial tympanic ring, and supporting＆. expanding Re-EAMs by EAM expandor and EAM model bracket, and worth of application .