Ⅰ形切口耳甲腔成形外耳道口截面积与形态学评估

Evaluation of cross-sectional area and morphological value of external auditory meatus in concha plasty withⅠshaped incision

目的:探讨经耳后Ⅰ形切口二瓣法耳甲腔成形术对术后外耳道口截面积与形态学改变的初步价值评估。方法:2018年6月-2019年12月于昆明医科大学第一附属医院耳鼻咽喉科行开放式乳突根治术并同期行Ⅰ形切口二瓣法耳甲腔成形术患者137例(155耳),分别于手术完成时与术后1个月及6个月测量外耳道口垂直径(D1)及水平直径(D2),根据两径值计算外耳道口截面积(S=1/4πD1×D2)。并于术后观察干耳时间、术腔上皮化时间;术后6个月统计外耳道口形态。结果:术后干耳时间为18~61 d,平均(27.32±7.52)d;术腔完全上皮化时间为24~70 d,平均(32.18±10.36)d。术后6个月复诊,155耳外耳道口形态分类情况:圆形(垂直径和水平径的差值在2 mm以内)者117耳(75.48%),椭圆形(外观呈椭圆,垂直径和水平径的差值大于2 mm)者35耳(22.58%),三角形者3耳(1.94%);无一例外耳道口呈不规则形态。术中及术后1个月及6个月外耳道口截面积分别为(2.51±0.48)cm^(2)、(2.45±0.35)cm^(2)、(2.41±0.43)cm^(2),差异无统计学意义(P>0.05)。结论:耳后Ⅰ形切口二瓣法耳甲腔成形术方法简单易行,术后外耳道口形态规则,不易缩窄,能有效匹配术腔通气。

Objective:To evaluate the preliminary value of the cross-sectional area and morphological changes of the external ear canal opening after the two-flap auriculoplasty through theⅠshaped posterior incision.Methods:One hundred and thirty-seven patients(a total of 155 ears)who received open radical mastoidectomy in the department of otolaryngology in the First Affiliated Hospital of Kunming Medical University were treated withⅠshaped incision and two-flap auriculoplasty.Vertical diameter(D1)and horizontal diameter(D2)of the external ear canal were measured at the completion of surgery,1 month and 6 months post-operation,respectively.The cross-sectional area(S=1/4πD1×D2)of the external ear canal was calculated according to the two diameters.The dry ear time and intraoperative lumen epithelialization time were observed after operation.At 6 months after operation,the morphology of the external ear canal opening was analyzed.Results:The postoperative dry ear duration was 18-61 days(27.32±7.52)days.The time to complete epithelialization of the operative cavity was 24-70 days(32.18±10.36)days.Six months after the operation,the morphological classification of 155 outer ear meatal openings was as follows:117 ears(75.48%)were round(the difference between vertical diameter and horizontal diameter was within 2 mm);Oval(oval appearance,difference between vertical diameter and horizontal diameter greater than 2 mm)35 ears(22.58%),triangle 3 ears(1.94%);Irregular ear canal orifice was not observed in all cases.During the operation,and at 1 month and 6 months after the operation,the cross-sectional area of the external ear canal was(2.51±0.48)cm^(2),(2.45±0.35)cm^(2),(2.41±0.43)cm^(2),respectively.And no significant differences were observed.(P>0.05).Conclusion:The I shaped posterior auricular incision and two-flap auricular lumenoplasty is not compex and easy to perform.The morphology of the external ear opening is regular after the operation,which can effectively match the ventilation of the operative cavity.