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[吊床式鼓膜成形术(技术、结果)]

[Hammock myringoplasty (technique, results)].

作者信息

Sauvage J P, Heurtebise F, Puyraud S

机构信息

C.H.U. Dupuytren, Service O.R.L., Limoges, France.

出版信息

Rev Laryngol Otol Rhinol (Bord). 1996;117(3):247-51.

PMID:9102735
Abstract

Since 1985, we have been using the so-called "hammock" technique in myringoplasty through the retro-auricular approach, with a temporal fascia graft positioned under what is left of the tympanum. The main feature of this technique lies in the creation of a cephaled tympano-meatal flap by a partial disinsertion of 4 to 5 millimetres of the cephalad part of the Gerlach annular labrurm, taking care to leave 2 millimetres of the labrum attached above the junction of the ephalad wall and the lower wall of the external auditory canal (anterior lower anchoring point). At the end of the operation, the graft is fixed both to the cephalad and to the caudad wall of the bony-external auditory canal like a hammock. This technique makes it possible to verify systematically the tympanic opening of the Eustachian tube. The use of biological glue is desirable, but not essential. The graft is stable enough for the implantation of Politzer's manoeuvre as from the seventh day and for Valsalva's manoeuvre from then on. Out of 213 operation, including all kinds of pathologies, 98% of good results were obtained as from the end of the first month, and 94.6% after three months.

摘要

自1985年以来,我们一直通过耳后入路在鼓膜成形术中使用所谓的“吊床”技术,将颞肌筋膜移植物置于鼓膜残余部分下方。该技术的主要特点在于通过部分离断Gerlach环形唇缘头侧部分4至5毫米来创建一个头侧鼓膜-耳道瓣,注意在耳道前下壁(前下固定点)与头侧壁交界处上方保留2毫米的唇缘附着。手术结束时,移植物像吊床一样固定在骨性外耳道的头侧和尾侧壁上。该技术能够系统地检查咽鼓管的鼓膜开口。使用生物胶是可取的,但不是必需的。移植物足够稳定,从第七天起就可以进行波利策尔手法操作,从那时起也可以进行瓦尔萨尔瓦手法操作。在包括各种病变的213例手术中,从第一个月末起获得了98%的良好效果,三个月后为94.6%。

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