Department of Otorhinolaryngology, Head and Neck Surgery, Huazhong University of Science and Technology Union Shenzhen Hospital (Nanshan Hospital), Shenzhen, P. R. China.
Acta Otolaryngol. 2022 Jul-Aug;142(7-8):543-548. doi: 10.1080/00016489.2022.2099014. Epub 2022 Jul 27.
Canalplasty is important in microscopic ear surgery, but it has rarely been studied in otoendoscopic surgery.
The aim of this study was to investigate the application of canalplasty due to external auditory canal stenosis caused by bony bulges in endoscopic myringoplasty.
The procedures and effects of canalplasties and myringoplasties were analysed. During the canalplasties, depending on the location of the bulges, the meatal skin flaps were elevated in different manners, and the underwater bone drilling technique was adopted to remove the bulges to enlarge the osseous canals.
Canalplasties were performed in 18.5% (33/178) of myringoplasties. All surgeries were completed exclusively via the transcanal endoscopic approach. No iatrogenic injuries were found. Most of the canalplasties required drilling off bulges on multiple walls. The mean total duration of the canalplasties and myringoplasties was 76.6 ± 4.5 min, and the proportion of time required for the canalplasties was 47.3 ± 2.4%.
Only approximately one in five endoscopic myringoplasties require antecedent canalplasties due to concurrent canal stenosis. With the underwater bone drilling technique, transcanal endoscopic canalplasty can be safely and efficiently conducted.
耳内镜手术中，耳道成形术十分重要，但在耳内镜手术中对此研究甚少。
本研究旨在探讨针对因骨性隆起导致的外耳道狭窄行内镜鼓膜成形术中应用耳道成形术的效果。
分析了耳道成形术和鼓膜成形术的步骤和效果。在行耳道成形术时，根据隆起的位置，以不同的方式掀起耳道皮瓣，采用水下骨钻技术去除隆起物以扩大骨性耳道。
在 178 例鼓膜成形术中，有 18.5%（33 例）进行了耳道成形术。所有手术均完全通过经耳道内镜入路完成，未发现医源性损伤。大多数耳道成形术需要在多个壁面上钻除隆起物。耳道成形术和鼓膜成形术的总平均手术时间为 76.6±4.5 分钟，其中耳道成形术所需时间的比例为 47.3±2.4%。
仅有约五分之一的内镜鼓膜成形术因同时存在的耳道狭窄而需要先行耳道成形术。采用水下骨钻技术，经耳道内镜的耳道成形术可以安全有效地进行。
