主要完成人冷同嘉 戴海江 郑雅丽赵守琴 郭继周 程继龙李霞 赵啸天 刘志莹于子龙主要完成单位首都医科大学附属北京同仁医院学科分类耳鼻咽喉科任务来源自选项目起止时间1980年1月～2000年12月项目详细内容立项背景先天性外中耳畸形的发病率约1/10000,是耳科较常见的畸形之一。其听力障碍和耳廓畸形严重影响着患者的身心健康,是一个急待解决的社会问题,多数患者迫切要求同时提高听力和美化耳廓外型。先天性耳畸形,颞骨解剖变异大,面神经畸形率高,如术中损伤面神经,后果较难挽回。如何达到听力提高又不伤及面神经,是耳显微听力外科的难题。尤其是重度畸形患者,是否行听力重建,国内外学者尚存在分歧,为避免发生并发症,也有主张不手术而佩带助听器者。全耳廓再造术属再造整形外科范畴,因其形状复杂,欲获再造耳成活、外形逼真,为整形外科之难题。整形外科之全耳廓再造与耳显微外科之听力重建手术时机的选择长期以来存在分歧与制约。从解剖生理方面考虑,只有先定位并建立宽敞外耳道和恢复听骨链运动后,方适宜在其后侧完成全耳廓再造术反之,若先行耳廓再造,则其外耳道一鼓室解剖部位将被遮挡,很难再行听力重建,患者只能遗憾地获单—效果。耳显微外科技术、计算机影像学技术的发展及电生理技术的应用,为该 Mainly completed Leng Tong Jia Dai Haijiang Zheng Yali Zhao Shouqin Guo Ji Zhou Chengji Li Xia Zhao Xiaotian Liu Zhiying Yu Zilong major units Beijing Capital Medical University Affiliated Beijing Tongren Hospital Discipline Otorhinolaryngology task source options from January 1980 to December 2000 project details Contents Project Background The incidence of congenital external middle ear deformity is about 1/10000, which is one of the more common deformities of otology. Its hearing impairment and auricle deformity seriously affect the patient’s physical and mental health, is an urgent social problem to be solved, most patients are urgently required to improve hearing and beautify the pinna shape. Congenital ear deformity, anatomical temporal bone changes, facial nerve deformity rate, such as intraoperative facial nerve damage, the consequences are more difficult to restore. How to improve the hearing without damaging the facial nerve is a difficult problem of otic microsurgical surgery. Especially severe deformity patients, whether hearing reconstruction, there are still differences between domestic and foreign scholars, in order to avoid complications, but also advocate not wearing a hearing aid. Full auricle reconstruction is a field of plastic surgery, because of its complex shape, to be recycled ear survival, realistic appearance, the plastic surgery problems. There is a long history of disagreements and constraints in the timing of whole ear reconstruction and ear microsurgery for reconstructive surgery in plastic surgery. From the anatomical and physiological point of view, only the first positioning and the establishment of a spacious external auditory canal and the recovery of the ossicular chain movement, the party is appropriate to complete the auricle reconstruction on the other side of the contrary, if the first auricle reconstruction, then the external auditory canal tympanic anatomy will be Obstruction, it is difficult to re-hearing reconstruction, patients can only regrettable single-effect. Ear microsurgery technology, the development of computer imaging technology and the application of electrophysiological technology, for the