鼓窦径路手术治疗先天性外耳道闭锁中耳畸形——附89例临床分析

目的 :探讨鼓窦径路治疗先天性外耳道闭锁中耳畸形的效果及重建耳道再闭锁的预防方法。方法 :回顾性分析 1993～ 1998年 5年间收治的 89例 (94耳 )先天性外耳道闭锁中耳畸形病人 ,均采用鼓窦径路重建外耳道 ,鼓室成形术 ,其中 型 80耳、加高 型 11耳、内耳开窗 3耳。康宁克通 A注射、扩张子扩张等预防耳道再闭锁。结果 :94耳均顺利找到鼓窦 ,开放鼓室 ,行听力重建 ,术后语言频率平均听力提高 2 0 d B以上者 80耳 (85 .1% ) ,提高 2 5 d B以上者 49耳(5 2 .1% )。再造耳道有闭锁征象者经康宁克通 A注射、扩张子扩张取得良好效果。结论 :鼓窦径路治疗先天性外耳道闭锁具有易掌握、安全、省时、效果可靠等特点 ,再造耳道有闭锁征象时应及时处理。

The surgical reconstruction of congenital aural atresia via tympanic antrum approach

Objective: To investigate the effect of surgical reconstruction of congenital aural atresia via tympanic antrum approach and the prevention for reatresia of the aural canal. Methods: From 1993 to 1998, 89 patients (94 ears) with congenital aural atresia were operated via tympanic antrum approach. All of them got aural canals reconstruction and tympanoplasty, including 80 ears of type Ⅱ, 11 ears of type Ⅲ and 3 ears for fenestration of inner ear. Kenacort|A and dilator were used to prevent reastresia of the aural canals. Results: The tympanic antrums of 94 ears were encountered smoothly, and their hearings were reconstructed. The hearing improvement were found over 20dB in 80 ears (85.1%), over 25dB in 49 ears (52.1%). Kenacort|A and dilator should be applied when the reastresia began to appear, and then the good effect could be made. Conclusion: It′s easy to master for surgical reconstruction of congenital aural atresia via tympanic antrum approach, and it also owns the characteristics of safety, save time and reliable effect. It should be managed as soon as the reastresia appears.