Ma K H, Fagan P A
Department of Otolaryngology, St. Vincent's Hospital, Sydney, Australia.
Laryngoscope. 1988 May;98(5):554-6. doi: 10.1288/00005537-198805000-00015.
Osteoradionecrosis of the temporal bone is a well-documented complication of radiotherapy to the ear, with potentially lethal complications. Three cases of advanced disease, treated surgically, are presented. In two of these, subtotal petrosectomy with blind-sac closure of the external auditory canal was carried out via an anterior approach. The enclosed space was obliterated with pedicled temporalis muscle. Primary healing took place. One case was similarly obliterated using a prolonged posterior incision. The wound broke down, requiring a microvascular free flap for closure. Radiotherapy jeopardizes the viability of skin flaps. An anterior incision bases the flap behind on the occipital and postauricular arteries. When radiotherapy has been used, this incision has theoretical and practical advantages over a standard posterior incision.
颞骨放射性骨坏死是耳部放疗的一种有充分文献记载的并发症，可能会引发致命并发症。本文介绍了3例采用手术治疗的晚期病例。其中2例通过前路行外耳道盲袋封闭的颞骨次全切除术，并用带蒂颞肌填塞封闭空间，实现一期愈合。1例采用延长后切口进行类似的封闭，伤口裂开，需要使用游离微血管皮瓣进行缝合。放疗会危及皮瓣的存活能力。前路切口使皮瓣的血供基于枕动脉和耳后动脉。当采用放疗时，与标准后切口相比，这种切口在理论和实际应用上均具有优势。
