骨桥在先天性小耳畸形伴外耳道闭锁中的应用

Application of Bone Bridge in Congenital Microtia with Aural Atresia

目的探讨骨桥在先天性小耳畸形伴外耳道闭锁患儿临床应用的效果。方法对5例先天性小耳畸形伴外耳道闭锁的患儿,行高密度聚乙烯(MEDPOR)支架植入耳廓再造术的同时于乳突腔骨质表面植入骨桥的骨传导装置(BCI),术后3~4周佩戴骨桥听觉处理器,评价患儿听力及言语功能的改变。结果随访3~14个月,术后纯音测听平均听力改善29.62 dB HL,平均气骨导差为20.58 dB HL,平均言语识别阈值提高43.46 dB HL,无眩晕、耳鸣、脑脊液漏及皮瓣感染等并发症发生。结论骨桥植入对于先天性小耳畸形伴外耳道闭锁患儿听力及言语功能改善明显,该方法操作简单,手术可与耳廓再造同期进行,减少了手术周期和费用,并发症少,值得临床推广应用。

Objective To report treatment outcomes of bone bridge in children with congenital microtia and ear ca-nal atresia.Methods Five children with congenital microtia with ear canal atresia received auricle reconstruction with high-density polyethylene(MEDPOR)framework and simultaneous implantation of bone conduction device(BCI)in the mastoid cavity.Bone bridge auditory processors were fitted three to four weeks after surgery,and hearing and speech function evaluated.Results During the 3-14 months of follow-up,the mean hearing improvement was 29.62 dB,with a mean air-bone gap of 20.58 dB,while the mean speech recognition threshold was improved by 43.46 dB.There were no complications such as vertigo,tinnitus,cerebrospinal fluid leakage or flap infection.Conclusion Bone bridge implantation can significantly improve hearing and speech function in children with congenital microtia with ear canal atresia.The treatment is simple,with few complications and good clinical outcomes.It can be performed simultaneously with auricle reconstruction to reduce operation times and cost.It is therefore a viable treatment option.