Rusetsky Yu Yu, Meitel I Yu, Anikin A V, Pashkova A E, Arutyunyan S K, Rozmanov E O, Krasivicheva O V
National Medical Research Center for Children's Health, Moscow, Russia.
Vestn Otorinolaringol. 2020;85(4):24-29. doi: 10.17116/otorino20208504124.
Main difficulties of endoscopic ear surgery in children could be connected with width of external ear canal (EEC) and endoscope diameter discrepancy.
To investigate EEC parameters in children, to determine cross section and to develop the recommendations whenever possible of endootosurgery performance in children.
Research included two stages. First - average values determination of narrowest site EEC in children according to computer tomograms. Second - determination of age of the patient and the amount of acoustical pass at which there are specifications for performance of interventions endoscopic.
EEC square: 1-3 years - 12.6±1.91 mm, diameter is 4.01±0.59 mm; 4-7 years - 16.8±1.34 mm, diameter is 5.34±0.43 mm; 8-11 years - 21.7±1.38 mm, diameter is 6.9±0.45 mm; 12-18 years - 31.3±4.27 mm, diameter is 9.96±1.4 mm. The difference between parameters at each of age groups was statistically reliable. Comfortable work endoscopically is possible with EEC square 20.4±3.19 mm and more. This corresponds to average value of EEC in 8-18 years.
Endoscopic ear surgery is inexpedient in children up to 4 years. It is necessary to expect that intervention will be exigeant and transition to the microscopic equipment is required in case of 4-7 years old patients. Endoscopic ear surgery can be used with success to performance of various manipulations and surgical interventions on a middle ear in patients 8-18 years old.
儿童内镜耳科手术的主要困难可能与外耳道（EEC）宽度和内镜直径差异有关。
研究儿童的外耳道参数，确定其横截面积，并尽可能制定儿童耳内手术操作的建议。
研究包括两个阶段。第一阶段——根据计算机断层扫描确定儿童外耳道最窄部位的平均值。第二阶段——确定患者年龄以及进行内镜干预操作时所需的声学通道量。
外耳道面积：1 - 3岁——12.6±1.91平方毫米，直径为4.01±0.59毫米；4 - 7岁——16.8±1.34平方毫米，直径为5.34±0.43毫米；8 - 11岁——21.7±1.38平方毫米，直径为6.9±0.45毫米；12 - 18岁——31.3±4.27平方毫米，直径为9.96±1.4毫米。各年龄组参数之间的差异具有统计学意义。外耳道面积为20.4±3.19平方毫米及以上时，内镜操作较为舒适。这与8 - 18岁儿童外耳道面积的平均值相对应。
4岁以下儿童不宜进行内镜耳科手术。对于4 - 7岁的患者，预计手术操作会较为复杂，必要时需改用显微镜设备。8 - 18岁的患者可成功地使用内镜耳科手术进行各种中耳操作和手术干预。
