自体皮质骨在Ⅲ型外耳道胆脂瘤手术中的应用

Application of autologous cortical bone in surgical treatment of type Ⅲ external auditory canal cholesteatoma

目的探讨自体皮质骨重建骨性外耳道后壁在手术治疗Ⅲ型外耳道胆脂瘤(external auditory canal cholesteatoma,EACC)中的应用。方法收集10例(11耳)临床诊断为Ⅲ型EACC患者,均一期行完壁式乳突切开+自体皮质骨外耳道后壁重建术+鼓室成形术治疗。结果术后随访10例(11耳)患者,10耳恢复外耳道的正常生理结构;1耳术后出现外耳道狭窄,给予膨胀海绵扩张3个月后恢复外耳道的正常生理结构。结论手术治疗Ⅲ型EACC中应用自体皮质骨重建外耳道后壁并同期行完壁式乳突切开+鼓室成形术,能彻底有效清除胆脂瘤、恢复外耳道及中耳正常生理结构、术后复发率低、听力提高满意,值得进一步应用观察。

OBJECTIVE To discuss the value of autologous cortical bone in surgical treatment of type III external auditory canal cholesteatoma(EACC).METHODS Ten patients with 11 ears with type III EACC who underwent intact canal wall mastoidectomy with tympanoplasty and canal wall reconstruction with autologous cortical bone.RESULTS During the follow-up,10 patients with 10 ears obtained normal physiological structure of the external auditory canal.One patient presented the stenosis of external auditory canal after operation,whose ear recovered from a three month expanding with expansion sponge.CONCLUSION Intact canal wall mastoidectomy with tympanoplasty and canal wall reconstruction with autologous cortical bone is proved to be an effective way for the treatment of patients with type III EACC to remove the cholesteatoma effectively,to obtain the normal physiological structure of the external auditory canal and to achieve a satisfying hearing.