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目的 探讨使用电刀直接做耳甲腔成形术对外耳道形状与大小的影响及术后临床疗效观察。方法 选取2022年1月至2024年2月于延边大学附属医院耳鼻喉科行开放式乳突切开术并同时使用电刀直接进行甲腔成形术的患者45例(45耳)作为研究对象，分别在手术完成之际、术后2周、术后1个月、术后6个月对外耳道形状进行评估，测量外耳道的垂直径(D1)、水平径(D2)，根据两径计算外耳道口横截面积(S=1/4πD1×D2)。并观察其术后干耳时间、术腔上皮化时间、有无术腔感染、外耳道口狭窄、软骨膜炎等并发症的发生。结果 术后干耳时间为28～52 d，平均(33.39±2.76)d，术后完全上皮化时间30～58 d，平均(38.33±1.98)d。术后6个月复查时外耳道形态为圆形者(垂直径与水平径的差值在2 mm内)43例(95%)，椭圆形(垂直径与水平径的差值>2 mm)者2例(5%)，术后完成之际、术后2周、术后1个月、术后6个月外耳道口的横截面积分别为(2.76±0.42)cm2、(2.76±0.42)cm2、(2.67±0.41)cm2、(2.63±0.40)cm2，差异无统计学意义(P>0.05)。结论 使用电刀直接做耳甲腔成形术方法简单易行，术后外耳道口形态规则、美观，不易狭窄，能有效的匹配术腔通气。
Abstract：Objective To report clinical outcomes of auricular concha reconstruction during mastoidectomy using direct electrocautery cutting, focusing on the shape and size of the external auditory canal. Methods Forty-five patients(45 ears) underwent open radical mastoidectomy at the Department of Otolaryngology, Yanbian University Hospital, during which the auricular concha was reshaped using electrocautery cutting techniques. Vertical(D1) and horizontal(D2) diameters of the external ear canal were measured at completion of surgery, 2 weeks, 1 and 6 months post-operation, together with calculation of the cross-sectional area(S=1/4πD1xD2). Time to dry ear and surgical cavity epithelialization was recorded, as well as the shape of the external ear canal at 6 months post-operation. Results Postoperative time to dry ear was 28-52(33.39±2.76) days. Time to complete cavity epithelialization was 30-58(38.33±1.98) days. At 6 months after the operation, the shape of the external ear meatal opening was round(vertical-horizontal diameter differential<2 mm) in 43 ears(95%) and oval(vertical and horizontal diameter differential> 2 mm) in 2 eras(5%), with no irregularity. The cross-sectional area of the external ear canal was measured at(2.76±0.42) cm2 at operation completion and at 2 weeks,(2.67±0.41) cm2 at 1 month, and(2.63±0.40) cm2 at 6 months after operation, respectively(P>0.05). Conclusion Direct electrocautery cutting can be used as a simple and easy technique to reshape the concha during radical mastoidectomy to achieve an external auditory canal opening of adequate size and shape that is resistant to post-operative constriction, to ensure sufficient ventilation of the surgical cavity.
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基本信息:
中图分类号:R764.9
引用信息:
[1]司淑瑞,朴峻辉,金香花,等.电刀在耳甲腔成形术中的临床效果分析[J].中华耳科学杂志,2025,23(06):780-784.
基金信息:
延边大学科技项目(ydkj202438)
2025-09-02
2025-09-02