van den Boer Cindy, van Spronsen Erik, Holland Carlijn T Q, Ebbens Fenna A, Waterval Jérôme J
Department of Otorhinolaryngology, Radboudumc, Nijmegen, Netherlands.
Department of Otorhinolaryngology, Amsterdam UMC, Amsterdam, Netherlands.
Ann Otol Rhinol Laryngol. 2019 Dec;128(12):1141-1146. doi: 10.1177/0003489419865562. Epub 2019 Jul 31.
Insertion of mold material into the middle ear is a complication of molding procedure for ear impression. These cases are referred to an ENT specialist. There is no standardized approach to this problem. Literature shows different clinical strategies. The aim of this study is to share our experience and to analyze the adverse outcome of different clinical approaches.
A case series of six patients with molding material inside the middle ear after complicated molding procedure for swimming earplugs are described. Additionally, available literature was reviewed to analyze results of the clinical approach after iatrogenic molding procedures. Forty-nine ears were included.
In-office removal of the material is associated with a significant risk of adverse outcome if the eardrum cannot be examined. This also accounts for ossicular involvement.
Temporal bone CT is advised in patients after complicated ear mold fitting if the tympanic membrane cannot be examined completely or the middle ear is involved. Blind removal should be avoided. Retroauricular transcanal tympanotomy or transmastoidal tympanotomy with facial recess approach is best practice in case the mold material has entered the middle ear. A clinical treatment algorithm is presented.
将模具材料插入中耳是耳印模制作过程中的一种并发症。这些病例会被转诊给耳鼻喉科专家。对于这个问题没有标准化的处理方法。文献显示了不同的临床策略。本研究的目的是分享我们的经验，并分析不同临床方法的不良后果。
描述了一系列6例在制作游泳耳塞的复杂印模过程后中耳内有模具材料的病例。此外，回顾了现有文献以分析医源性印模制作程序后临床方法的结果。共纳入49只耳朵。
如果无法检查鼓膜，在门诊取出材料会有显著的不良后果风险。这也涉及听小骨受累情况。
对于复杂耳模佩戴后鼓膜无法完全检查或中耳受累的患者，建议进行颞骨CT检查。应避免盲目取出。如果模具材料已进入中耳，耳后经耳道鼓室切开术或经乳突鼓室切开术联合面神经隐窝入路是最佳做法。并给出了临床治疗算法。
