防止再造外耳道再闭锁与狭窄的新策略和方法

发布时间：2019-04-18 19:35

【摘要】：目的探索先天性外耳道闭锁/狭窄耳道再造术后防止再闭锁/狭窄新的策略与方法。方法根据作者临床观察再造耳道再闭锁/狭窄的特点,提出了一系列新的预防策略和方法,并研究、设计了相关专利产品。包括改善覆盖上皮种类与方法、模拟鼓环功能、加强术后支撑与扩张。结果再狭窄/闭锁发生率在中厚皮片拼接法16.9%(10/59),明显低于替尔氏皮片桶状植皮34%(17/50)(p0.05)与拼接植皮45.5%(15/33)(p0.01),而后两者间及其它方法间无明显差异(p0.05);人工鼓环模拟鼓环功能效果明显;外耳道扩张器与耳道模型支架能起明显的扩张和支撑作用。结论中厚皮片拼接加人工鼓环置入及术后有效的支撑和扩张是防止再造外耳道再狭窄或闭锁新的有效的方法,在临床值得推广应用。
[Abstract]:Objective to explore a new strategy and method to prevent re-atresia / stenosis after congenital atresia / stenosis reconstruction of external auditory meatus. Methods according to the clinical observation of re-atresia / stenosis of the reconstructed auditory canal, a series of new preventive strategies and methods were put forward, and the patent products were designed. It includes improving the types and methods of covering epithelium, simulating the function of tympanic ring, strengthening postoperative support and dilation. Results the incidence of restenosis / atresia was 16.9% (10 / 59) in moderate and thick skin graft, which was significantly lower than that in Till's skin graft (34% (17 / 50) (p0.05) and splicing skin grafting (45.5% (15 / 33) (p0.01). There was no significant difference between the latter two methods and other methods (p0.05). The artificial tympanic ring can simulate the tympanic ring function obviously, and the external auditory canal expander and the model bracket of the auditory canal can play an obvious role in dilating and supporting the tympanic ring. Conclusion it is a new effective method to prevent restenosis or atresia of the reconstructed external auditory meatus with middle and thick skin graft splicing and artificial tympanic ring implantation and effective support and expansion after operation. It is worth popularizing and applying in clinical practice.
【作者单位】：解放军总医院耳鼻咽喉头颈外科;
【基金】：国家自然基金专项基金项目(31340055,31140047) 解放军总医院专利转化基金项目(42411D19) 解放军总医院苗圃基金项目(07MP24)联合资助
【分类号】：R764

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