耳轮棘在儿童复杂性耳前瘘管手术中的意义

The significance of the spine of helix in the operation of complex preauricular fistulas in children

目的:探讨耳轮棘部分切除在儿童复杂性耳前瘘管手术中的应用意义。方法:回顾性分析2017年6月—2021年2月收治的78例复杂性耳前瘘管患儿临床资料和局部病变特点,探讨耳轮棘在术中的意义。结果:78例患者自然瘘口均位于耳轮脚前方,其中73例瘘管紧贴耳轮软骨膜达耳轮棘,5例既往手术已切除瘘口的复发病例残留病变均位于耳轮棘。全部病例术后均无复发。结论:手术是根治复杂性耳前瘘管的唯一方法,术中主动解剖耳轮棘可显露深部病变位置和范围,耳轮棘部分切除可减少复发,也可避免因耳轮软骨切除过多导致局部畸形。

Objective:To explore the application significance of partial spine of helix resection in the operation of complex preauricular fistula in children.Methods:A retrospective analysis of the clinical data and local lesion characteristics of 78 children with a complex preauricular fistula admitted to Henan Provincial Children's Hospital from June 2017 to February 2021,exploring the intraoperative significance of the spine of helix.Results:Part of the spine of helix,perichondrium and part of the soft tissue were excised completely by anatomical resection,and the natural fistula in 78 patients were all located in front of the crus of helix,among which,73 cases had a fistula close to the perichondrium of the helix and reached the spine of helix.The residual lesions,in the 5 cases of recurrence without a fistula in previous surgery patients,were all located in the spine of helix.There was no recurrence after operation in all cases.Conclusion:Surgery is the only way to radically cure complex preauricular fistulas.Active dissection of the spine of helix during surgery can reveal the location and extent of deep lesions.Partial excision of the spine of helix can effectively cure and reduce recurrence,and also avoid local deformities caused by excessive helical cartilage excision.