中耳手术乳突填塞材料的研究进展

Research Advances on Materials Used in Mastoid Obliteration

传统中耳乳突手术(如开放式乳突根治)术后常遗留巨大乳突术腔,可导致术腔皮屑积聚、反复耳漏与感染等不良反应,患者需在门诊定期清理,亦不能参与水上运动项目。乳突填塞术为运用各类材料填塞乳突术腔,旨在消除或缩小乳突术腔,以促进干耳、减少术腔清理与术后并发症发生率,从而提高患者生活质量。临床上,我们通常使用骨粉或软组织瓣等自体材料进行填塞,近年来也逐渐兴起使用同种异体材料和合成类材料。虽然目前填塞材料的可选择范围较广,但至今尚缺乏一种理想的乳突填塞材料。因此,本文将对各类乳突填塞材料及其临床应用进行总结与分析,并探讨现代耳科手术中使用此类材料的临床考量。

Traditionally,middle ear surgery(e.g.canal wall down mastoidectomy)may leave a large mastoid cavity postoperatively,which can lead to debris retention,chronic otorrhea and recurrent infections.As a result,patients often need regular toileting in office with restrictions on water exposure.Various materials have been used to obliterate the residual mastoid cavity.The purpose is to reduce its volume,thereby achieving a dry ear,reducing the need for toileting and complications,and improving quality of life.Generally,autologous materials such as bone pate and soft tissue flaps are used for mastoid obliteration.Over time,allogeneic and synthetic materials have been introduced as well.Despite the availability of various materials,an ideal material is yet to be identified.This article aims to summarize the different types of materials utilized in mastoid obliteration and their clinical applications,and discuss clinical considerations in using such materials in contemporary ear surgery.