Chang S O, Min Y G, Kim C S, Koh T Y
Department of Otolaryngology, Seoul National University College of Medicine, Korea.
Laryngoscope. 1994 May;104(5 Pt 1):606-11. doi: 10.1002/lary.5541040514.
Congenital aural atresia is a relatively common anomaly in otology. It requires an early assessment of hearing status and an early evaluation of the degree of atresia. Its surgical management is aimed at obtaining hearing gain and at establishing appropriate auditory canal status for the application of hearing aids. The authors analyzed the preoperative otologic findings, surgical findings, postoperative complications, and postoperative hearing results of 25 ears in 21 patients with congenital aural atresia. From January 1987 to February 1992, 24 of these ears were surgically corrected by anterior approach; the remaining 1 was corrected by transmastoid approach. Postoperative audiologic follow-up ranged from 8 months to 4 years (N = 21). A new modification of anterior approach is introduced. The final average air-bone gap was 30 dB, in contrast to preoperative 53 dB (N = 21). The final air-bone gap was improved to a level within 30 dB in 52% of the patients. Meatal stenosis was the most frequent postoperative complication and was seen in 12 patients in primary operation (N = 25). There was no postoperative facial nerve palsy and no sensorineural hearing loss. There was little difference in postoperative hearing among the various types of congenital aural atresia and the type of tympanoplasty that had been performed.
先天性耳道闭锁是耳科学中一种相对常见的异常情况。它需要对听力状况进行早期评估以及对闭锁程度进行早期评估。其手术治疗旨在提高听力并为使用助听器建立合适的耳道状况。作者分析了21例先天性耳道闭锁患者25只耳朵的术前耳科检查结果、手术发现、术后并发症及术后听力结果。从1987年1月至1992年2月，其中24只耳朵通过前路手术矫正；其余1只通过经乳突手术矫正。术后听力随访时间为8个月至4年（N = 21）。介绍了一种前路手术的新改良方法。最终平均气骨导差为30dB，而术前为53dB（N = 21）。52%的患者最终气骨导差改善到30dB以内。外耳道狭窄是最常见的术后并发症，在初次手术的12例患者中出现（N = 25）。术后无面神经麻痹及感音神经性听力损失。不同类型的先天性耳道闭锁及所施行的鼓室成形术类型之间术后听力差异不大。
