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使用合成皮肤替代物的两阶段耳道闭锁和狭窄手术。

Two-stage aural atresia and stenosis surgery with the use of synthetic skin substitute.

作者信息

Yildirim Nadir, Yildirim Nadir, Sahan Murat, Kasapoğlu Fikret

机构信息

Department of Otolaryngology Head & Neck Surgery, Yuzuncuyil University Medical Faculty, Van, Turkey.

出版信息

Acta Otolaryngol. 2009 Oct;129(10):1072-9. doi: 10.1080/00016480802552535.

Abstract

CONCLUSION

With this technique, patency rates achieved in congenital external ear canal (EAC) atresia/stenosis and improvement in hearing were evaluated as 'good' and 'satisfactory', respectively.

OBJECTIVES

We aimed to test the efficacy of a novel two-stage technique in preventing restenosis following atresioplasty.

PATIENTS AND METHODS

Nine patients with congenital EAC atresia/stenosis comprised our cases. We performed 10 atresioplasties using the two-stage technique described below. In the first stage, the ear canal is drilled and its wall is covered with a synthetic skin replacement that induces proliferation of a soft tissue; in the second stage this is lined underneath with split thickness skin graft. Operations were complemented with tympanoplasties in five of the patients.

RESULTS

Nine (91%) of 10 operations carried out with the technique were largely successful in terms of patency. The achieved average hearing gain was air conduction/bone conduction (Ac/Bc): 31.33/9.44 dBHL (21.89 in the air-bone gap), while the postoperative air-bone conduction gap was changed to <30 dBHL in eight (88.9%) of the patients.

摘要

结论

采用该技术,先天性外耳道闭锁/狭窄的通畅率评估为“良好”,听力改善评估为“满意”。

目的

我们旨在测试一种新型两阶段技术在防止闭锁成形术后再狭窄方面的疗效。

患者与方法

我们的病例包括9例先天性外耳道闭锁/狭窄患者。我们使用下述两阶段技术进行了10次闭锁成形术。在第一阶段,对外耳道进行钻孔,并用诱导软组织增殖的人工皮肤替代物覆盖其壁;在第二阶段,在其下方衬以中厚皮片。5例患者的手术辅以鼓室成形术。

结果

采用该技术进行的10次手术中有9次(91%)在通畅方面基本成功。获得的平均听力增益为气导/骨导(Ac/Bc):31.33/9.44 dBHL(气骨导差为21.89),而8例(88.9%)患者术后气骨导差变为<30 dBHL。

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