耳内镜鼓膜修补术后并发耳廓软骨膜炎2例并文献复习

Auricular perichondritis complication of endoscopic tympanic membrane repair: report of two cases and review of the literature

摘要:

目的 报道2例耳内镜鼓膜修补术后并发耳廓软骨膜炎患者的病历资料，为临床医师提供参考。方法 对2例耳内镜鼓膜修补术后并发耳廓软骨膜炎患者采用抗炎、对症等治疗，对脓肿形成者广泛切开引流，清理坏死软骨。结合文献复习阐述耳廓软骨膜炎的发病原因、临床特点及治疗方法。结果 患者1随访4个月后复查右耳廓上端稍有塌陷畸形，修补鼓膜愈合良好，患者自觉听力改善，声阻抗示A型，纯音测听示气骨导差基本消失；患者2随访2个月后见伤口局部无渗出，切口逐渐对位愈合。结论 由于耳内镜鼓膜修补技术的广泛开展，对于耳屏软骨的操作增加。临床医生需警惕术后耳廓化脓性软骨膜炎的发生。手术中严格消毒，术后做好切口观察护理。发生后应早诊断，早治疗，尽可能减少耳廓畸形的发生。

Abstract:

Objective To report the medical records of two patients with auricular perichondritis after endoscopic tympanic mem-brane repair for the purpose of clinical reference. Methods Two patients with auricular perichondritis after endoscopic tympanic membrane repair were treated with anti-inflammatory and symptomatic treatment, and the abscess was extensively cut open and drained to clean the necrotic cartilage. This paper analyzed the etiology, clinical characteristics and treatment of auricular perichon-dritis by combining literature review. Results Patient No. 1 was followed up for 4 months, who had slightly collapsed deformity at the upper portion of the right auricle. The repaired tympanic membrane healed well. The patient's conscious hearing improved. Acoustic impedance showed Type A. Pure tone audiometry showed that the air bone conduction difference basically disappeared. In the second patient, there was no local exudation from the wound after 2 months of follow-up, and the incision gradually healed in para-position. Conclusions Due to the extensive development of tympanic membrane repair technology, the operation of tragus carti-lage has increased. Clinicians need to be alert to the occurrence of auricular suppurative chondritis. Strict disinfection during the operation and observation and nursing care after the incision. Early diagnosis and treatment should be performed after the occurrence to minimize auricle deformities.