中耳炎手术中保留完整外耳道皮瓣的临床研究

目的探讨中耳炎手术中保留外耳道皮瓣完整性的临床应用和治疗效果。方法根据对外耳道皮瓣处理方法的不同，将70例中耳炎手术的病人分为两组，一组为保留外耳道皮瓣完整性组37例，另一组为传统切开外耳道皮瓣组33例。同期行鼓室成形术，术后耳内镜随访6个月，对比两组在创面生长肉芽及干耳时间方面的差异，并进行统计分析。结果保留外耳道皮瓣完整性组术腔肉芽发生率为8．1％，干耳时间平均5．3周；剪开皮瓣组术腔肉芽发生率30．3％，干耳时间平均7．2周。两组的差异均有统计学意义（P〈0．05）。结论中耳炎手术中保留外耳道皮瓣的完整性适宜于乳突腔小的病人，较传统切开皮瓣组术后肉芽发生率低，干耳时间短，耳道直径无明显缩小，其长期的效果及并发症尚待进一步的跟踪随访研究。

Clinical study of retaining the integrity of ear canal skin flap in otitis media surgery

Objective To discuss the clinical application and effect of retaining the integrity of ear canal skin flap in otitis media surgery. Methods 70 patients through otitis media surgery were divided into two groups, including 37 patients for intact ear canal skin flap and 33 for dissected flap. Results The follow-up period was 6 months. In the group of intact skin flap, the occurrence rate of granulation was 8.1 % and the average time of dry ear was 5.3 weeks. In the other group, the occurrence rate of granulation was 30. 3% and the average time of dry ear was 7.2 weeks. There was significant difference between the two groups. Conclusion Retaining the integrity of ear canal skin flap in otitis media surgery is suitable for patients with small mastoid cavity. It has lower occurrence rate of granulation and shorter time of dry ear than the traditional group. Its long-term effects and complications should be further follow-up study.