Kuczkowski Jerzy, Sierszeń Wojciech, Narożny Waldemar, Gulida Grażyna
Katedra i Klinika Otolaryngologii Gdańskiego Uniwersytetu Medycznego, Poland.
Otolaryngol Pol. 2012 Nov-Dec;66(6):387-91. doi: 10.1016/j.otpol.2012.06.010. Epub 2012 Jun 18.
Acquired post inflammatory external auditory canal atresia is a rear complication of external ear disease. It is presented as a connective tissue scar in bony part of external auditory canal. The aim of this study is clinical and epidemiological analysis and presentation of diagnostics and treatment results of patients with atresia treated in the Otolaryngology Department of Medical University of Gdansk.
In the period of 3 years (2008-11) 10 patients (8 women and 2 men) aged 30 to 70-years-old (medium 53 years) were treated for acquired atresia. All of these patients had medial closure of EAC with thick connective tissue scar and tympanic membrane involvement. Intrameatal access was performed in 5 patients, intraural access in 3 patients and retroaurical access in 2 patients. In all cases canaloplasty with meato-tympanic angle enlargement was performed, skin defect was replaced with free epidermal flap, silicon foil with fibrinous sponge was used for coverage.
In all of our patients external auditory canal widening and hearing improvement was achieved. Due to increasing EAC narrowing four patients underwent second surgery with another free epidermal flap grafting.
The selection of surgical access in patients with acquired atresia should comply with the etiology of the disease and the shape of EAC. During surgery we aim at maximal broadening of the bony part of EAC. The success of the treatment depends on meato-tympanic angle enlargement and free epidermal flap grafting.
获得性炎症后外耳道闭锁是一种外耳道疾病的罕见并发症。它表现为外耳道骨部的结缔组织瘢痕。本研究的目的是对格但斯克医科大学耳鼻喉科治疗的闭锁患者进行临床和流行病学分析，并展示诊断和治疗结果。
在3年期间（2008 - 11年），对10例年龄在30至70岁（平均53岁）的患者（8名女性和2名男性）进行了获得性闭锁的治疗。所有这些患者的外耳道内侧均有致密结缔组织瘢痕闭锁且鼓膜受累。5例患者采用耳道内入路，3例患者采用耳内入路，2例患者采用耳后入路。所有病例均进行了外耳道成形术并扩大了外耳道鼓室角，用游离表皮瓣替代皮肤缺损，使用含纤维海绵的硅箔进行覆盖。
我们所有患者均实现了外耳道增宽和听力改善。由于外耳道狭窄加重，4例患者接受了第二次手术并再次进行游离表皮瓣移植。
获得性闭锁患者手术入路的选择应符合疾病病因和外耳道的形态。手术过程中我们旨在最大程度地扩大外耳道的骨部。治疗的成功取决于外耳道鼓室角的扩大和游离表皮瓣移植。
