Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
Otolaryngol Head Neck Surg. 2012 Apr;146(4):614-20. doi: 10.1177/0194599811426257. Epub 2011 Oct 20.
Postoperative external auditory canal (EAC) stenosis is the most common complication after congenital aural atresia (CAA) surgery. The authors applied an ear mold or hearing aid as an EAC stent following surgery and analyzed the impact on postoperative EAC stenosis.
Historical cohort study.
A tertiary hospital.
Ninety-six patients who underwent canaloplasty between 1996 and 2010 were included in this study. To discover factors contributing to postoperative EAC stenosis, clinical parameters, including age, sex, Marx grading, Schuknecht classification, Jahrsdoerfer score, surgical approach, triamcinolone injection, and use of stenting with an ear mold or hearing aid, were reviewed and analyzed. Each stent was used for at least 6 months postoperatively. Pure-tone audiometry was performed preoperatively and 3, 6, and 12 months after canaloplasty.
Postoperative EAC stenosis was the most common postoperative complication, occurring in 8 (8.2%) cases with a mean time interval of 4.1 months. For patients who did not use an ear mold or a hearing aid during the postoperative follow-up period, the relative risk for the development of postoperative EAC stenosis was 5.125 (95% confidence interval, 1.428-18.400; P = .023). Other factors did not show an association with postoperative stenosis. Preoperative air-bone gap (ABG) was 49.00 dB, and closure of the ABG within 30 dB was obtained in 56.9%, 58.1%, and 48.7% of patients at the 3-, 6-, and 12-month follow-up, respectively.
Stenting with an ear mold or hearing aid might be a useful method for preventing postoperative EAC stenosis in CAA patients.
先天性外耳道闭锁(CAA)手术后,最常见的并发症是术后外耳道狭窄。作者在手术后应用耳模或助听器作为外耳道支架,并分析其对术后外耳道狭窄的影响。
回顾性队列研究。
三级医院。
本研究纳入了 1996 年至 2010 年间行耳道成形术的 96 例患者。为了发现导致术后外耳道狭窄的因素,对包括年龄、性别、Marx 分级、Schuknecht 分类、Jahrsdoerfer 评分、手术方式、曲安奈德注射以及使用耳模或助听器支架等在内的临床参数进行了回顾性分析。每个支架术后至少使用 6 个月。术前及术后 3、6、12 个月进行纯音测听。
术后外耳道狭窄是最常见的术后并发症,8 例(8.2%)患者发生,平均时间间隔为 4.1 个月。对于术后随访期间未使用耳模或助听器的患者,术后发生外耳道狭窄的相对风险为 5.125(95%置信区间,1.428-18.400;P=.023)。其他因素与术后狭窄无关。术前气骨导差(ABG)为 49.00dB,56.9%、58.1%和 48.7%的患者分别在术后 3、6 和 12 个月时获得了 30dB 以内的 ABG 闭合。
对于 CAA 患者,应用耳模或助听器支架可能是预防术后外耳道狭窄的一种有效方法。