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目的:探讨Fisch技术在预防先天性外耳道闭锁重建后再闭锁和狭窄的临床意义。方法:分析2000年1月~2006年6月收治的73例(74耳)先天性外耳道闭锁中耳畸形患者,均采用鼓窦径路手术入路,术中用Fisch技术重建外耳道。59耳(79.72%)获随访6个月~5年。结果:59耳中有2耳(3.38%)狭窄,主要在外耳口以下,无一耳闭锁。49耳(83.05%)术后听力结果长期稳定,10耳(16.95%)因成形鼓膜增厚而听力下降(均大于15 dB)。结论:Fisch技术能有效预防先天性外耳道闭锁重建后再闭锁和狭窄。但术后的定期随访和炎症控制也是不可缺少的手段。
Objective: To investigate the clinical significance of Fisch technique in prevention of atresia and stenosis after congenital external auditory canal atresia. Methods: From January 2000 to June 2006, 73 patients (74 ears) with congenital external auditory canal middle ear malformation were enrolled in this study. All the patients were treated by the method of transoral sinus approach. The external auditory canal was reconstructed with Fisch technique. 59 ears (79.72%) were followed up for 6 months to 5 years. Results: There were 2 ears (3.38%) stenosis in 59 ears, mainly below the outer ear mouth, and none of the ears were closed. 49 ears (83.05%) had stable long-term postoperative hearing, and 10 ears (16.95%) had hearing loss due to thickening of the tympanic membrane (both greater than 15 dB). Conclusion: Fisch technique can effectively prevent atresia and stenosis after congenital external auditory canal atresia. However, regular postoperative follow-up and inflammation control are also indispensable tools.