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现阶段占优势的意见是应该在鼓室成形术中保留或重建外耳道。但手术技术较复杂;术野深小,妨碍明视,稍不仔细,病变清除难以彻底;术后胆脂瘤复发率和术腔化脓率均较高;另外,用移植骨或软骨重建外耳道,移植物营养不足,愈合困难。有鉴于斯,作者根据病变的特征和范围,制定了三种耳道成形术新法,所用材料为带蒂的骨膜瓣。第一法适用于慢性化脓性上鼓室炎伴上鼓室胆脂瘤,听骨链完整或破坏;也适用于复发性慢性化脓性中鼓室炎。手术步骤如下: 1.耳后切口,将软组织与骨膜分开。 2.将骨膜剪裁成带蒂的移植片,蒂位于耳廓后缘附近,宽度相当于由颞线到耳道下壁,长度2倍于宽度。剥离外耳道后壁皮肤。 3.处理骨质: (1)乳突胆脂瘤时广泛开放气房,凿除骨性
The prevailing opinion at this stage is that the external auditory meatus should be retained or reconstructed during tympanoplasty. But the surgical technique is more complicated; the surgical field is small and small, hinder the bright vision, a little not careful, difficult to completely remove the disease; postoperative cholesteatoma recurrence rate and intraoperative pus rate are higher; In addition, with bone graft or cartilage reconstruction of the external auditory meatus, Insufficient graft, healing difficulties. In view of Sri Lanka, according to the characteristics and scope of the disease, the author developed three new methods of ear canal angioplasty, the material used is pedicled periosteal flap. The first method is suitable for chronic suppurative upper tympanitis with tympanic cholesteatoma, complete or disrupted ossicular chain; also applies to recurrent chronic suppurative tympanitis. Surgical procedures are as follows: 1. Ear incision, the soft tissue and periosteal separation. 2. The periosteum cut into pedicled grafts, pedicle located in the auricle posterior margin, the equivalent width from the temporal line to the ear canal wall, the length of 2 times the width. Peel the outer wall of the posterior wall of the skin. 3. To deal with bone: (1) mastoid cholesteatoma wide open air rooms, chiseling bones removed