耳后带蒂复合皮瓣移植填塞乳突术腔 并重建外耳道后壁

目的探讨陈旧性根治性乳突术腔填塞及外耳道后壁缺损的修复方法。方法采用耳后带蒂复合皮瓣移植，对10例(11耳)行乳突根治术后1～6年的患者，行陈旧性乳突术腔填塞及外耳道后壁缺损重建术，并同期行鼓室成形术。结果术后随访3～30个月，全部患者乳突术腔消失，外耳道大小接近正常；术后干耳时间2～3周，“根治腔病”症状明显好转，平均听阈下降13.6dBHL。结论本方法缩短了术后干耳时间，对乳突根治术后的“根治腔病”具有明显的治疗效果，有利于鼓室成形术。

Application of posterior canal wall reconstruction and mastoid obliteration

Objective:To explore the obliteration of the old mastoid cavity and reconstruction of the posterior canal wall after radical mastoidectomy.Method:Posterior canal wall reconstruction and mastoid obliteration of 11 ears of 10 patients with old mastoid cavity for 1 to 6 years after radical mastoidectomy were done using the pedicle postauricular composite skin flap (PPCSF),and their tympanoplasty were performed at the same time.Follow up was performed at 3 to 30 months.Result:All PPCSFs survived.The old mastoid cavity of 11 ears vanished and reconstructed posterior canal wall remained in normal position without retraction.The drying ear time took 2 to 3 weeks postoperatively,and the symptoms of the radical cavity disease after radical mastoidectomy were cleared up nearly,and the average hearing threshold decreased 13.6 dB HL.The otorrhea and perforation of tympanic membrane resulted from infection happened to 1 of 11 ears three month after the operation.Conclusion:The PPCSF is an effective method in the obliteration of old mastoid cavity and reconstruction of the posterior canal wall.It can reduce drying ear time postoperatively,treat the radical cavity disease after radical mastoidectomy and is beneficial to the tympanoplasty at the posterior external at the same time.