Wan Liang-cai, Guo Meng-he, Xie Nan-ping, Liu Shuang-xiu, Chen Hao, Gong Jian, Chen Shuai-jun
Department of Otolaryngology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China. wanliangcai@ 126.com
Nan Fang Yi Ke Da Xue Xue Bao. 2009 May;29(5):1057-9.
To assess the effect of surgical reconstruction of congenital aural atresia via the mastoid antrum approach and investigate method for preventing postoperative atresia of the reconstructed aural canal.
From 2000 to 2008, aural canal reconstruction and tympanoplasty was performed via the mastoid antrum approach. In 48 patients with congenital aural atresia (54 ears, including 45 ears of type II, 9 ears of type III). All the patients were followed-up for 18 months to assess the therapeutic effect.
The mastoid antrum was located uneventfully for all the 54 ears, all showing ossicular chain anomalies involving most frequently the malleus and the incus followed by the upper structures of the stapes. Facial nerve abnormalities were seen in 23 ears (42.6%). Hearing improvement to over 20 dB was achieved in 45 ears (83.3%) and to over 25 dB in 25 ears (46.2%) one year later.
The mastoid antrum approach for surgical reconstruction of congenital aural atresia is safe and reliable. Maintenance of the width of the aural canal and prevention of lateral healing of the transplanted tympanic membrane are crucial in the treatment of congenital aural atresia.
评估经乳突窦入路手术重建先天性耳道闭锁的效果，并探讨预防重建耳道术后闭锁的方法。
2000年至2008年，采用经乳突窦入路进行耳道重建和鼓膜成形术。对48例先天性耳道闭锁患者（54耳，其中Ⅱ型45耳，Ⅲ型9耳）进行手术。所有患者均随访18个月以评估治疗效果。
54耳均顺利找到乳突窦，均显示听骨链异常，最常见的是锤骨和砧骨，其次是镫骨上部结构。23耳（42.6%）出现面神经异常。术后1年，45耳（83.3%）听力提高超过20dB，25耳（46.2%）听力提高超过25dB。
经乳突窦入路手术重建先天性耳道闭锁安全可靠。维持耳道宽度及防止移植鼓膜外侧愈合是治疗先天性耳道闭锁的关键。
