自Lew is(1975)倡用颞骨切除术治疗耳道和中耳癌以来,术后加用放疗五年生存率由6%提高到30%左右。手术技巧和闭合伤口的方法对术后及早放疗至关重要。本文综述了颞骨切除术后各种修复方法并介绍一种新方案。本法多采用耳郭前、后及外耳道下三点连结皮肤切口。牺牲耳郭及邻近皮肤时则采用后颈部转移皮瓣及松弛切口。为争取颞骨次全切除术后伤口顺利一期愈合,应注意封闭死腔,减张缝合,保留皮瓣血供,避免“T”形连结(尤其是跨越死腔者),预防脑脊液漏等并发症。作者建议改用单一切口,自耳郭前颧弓上方开始延至下颌角下,切口稍向后弯,再向前下。术野暴露良好。若手术顺利,不用过多牺牲周围皮肤或腮腺,皮瓣血供未受影 Since Lew is (1975) advocated the use of temporal bone resection for the treatment of the ear and middle ear cancers, the five-year survival rate after radiotherapy combined with radiotherapy increased from 6% to 30%. Surgical techniques and procedures to close the wound are essential for early postoperative radiotherapy. This article reviews various repair methods after temporal bone resection and introduces a new program. This method and more use of the ear before and after the ear canal and three points under the skin incision. Sacrificial ear and adjacent skin when the neck is used to transfer the flap and relaxation of the incision. In order to strive for the healing of the wounds after subtotal resection of the temporal bone, it is necessary to pay attention to sealing the dead space, reducing the sutures and reserving the blood supply of the flaps, avoiding “T” shaped connections (especially those crossing the dead space) and preventing cerebrospinal fluid leakage disease. The authors suggest switching to a single incision, starting from the top of the zygomatic arch before the ear began to extend to the mandibular angle, incision slightly backward bend, then forward. Surgery exposed well. If the operation goes well, not too much sacrifice the surrounding skin or parotid gland, flap blood supply is not affected