耳内镜下耳道入路外翻外耳道皮瓣与显微镜乳突入路治疗耳道狭窄复发中耳胆脂瘤疗效分析

Analysis of the therapeutic effect of endoscopic approach with external ear flap and microscopic mastoid approach for the treatment of recurrent middle ear cholesteatoma caused by ear canal stenosisWANG Ying, GUAN Bing, XU Li,MA Wei,LU Jie, JI Xinya,YAN Qi,LU Xiuyue,ZHU Bin

摘要:

目的 探讨耳内镜下耳道入路外翻外耳道皮瓣与显微镜乳突入路治疗耳道狭窄复发中耳胆脂瘤的疗效。方法 回顾2021年6月～2024年1月在扬州大学附属苏北人民医院接受手术的60例(60耳)耳道狭窄复发中耳胆脂瘤患者的临床资料,采用耳内镜下耳道入路外翻外耳道皮瓣手术(耳内镜组)29例,显微镜乳突入路手术(显微镜组)31例,评估耳内镜下耳道入路外翻外耳道皮瓣手术与显微镜乳突入路手术在治疗耳道狭窄复发中耳胆脂瘤的手术时间、术后疼痛、并发症与复发之间的关系。结果 耳内镜组与显微镜组的人口统计学、疾病特征、并发症、复发率间均无显著差异(p<0.05)。耳内镜组与显微镜组的手术时间、术后疼痛VAS评分有显著差异,耳内镜组用时更少,疼痛更小,更具优势(p<0.05)。结论 耳内镜下外翻外耳道皮瓣治疗耳道狭窄复发中耳胆脂瘤是一种有效的手术方法,由经验丰富的外科医师进行操作,其疗效与显微镜乳突入路手术相似,用时更少,疼痛更轻。

Abstract:

OBJECTIVE To investigate the efficacy of endoscopic approach with external ear flap and microscopic mastoid approach in the treatment of recurrent middle ear cholesteatoma caused by ear canal stenosis. METHODS? The clinical data of 60 patients (60 ears) with recurrent middle ear cholesteatoma due to ear canal stenosis who underwent surgery at the Affiliated Subei People"s Hospital of Yangzhou University from June 2021 to January 2024 were retrospectively reviewed. 29 cases underwent endoscopic external ear canal flap surgery (endoscopic group) and 31 cases underwent endoscopic breast insertion surgery (microscopic group). The relationship between the surgical time, postoperative pain, complications, and recurrence of ear canal stenosis and recurrent middle ear cholesteatoma was evaluated using endoscopic external ear canal flap surgery and endoscopic mastoid approach surgery. RESULTS There were no significant differences (p<0.05) in demographic, disease characteristics, complications, and recurrence rates between the otoscope group and the microscope group. There were significant differences in surgical time and postoperative pain VAS scores between the otoscope group and the microscope group, with the otoscope group taking less time, experiencing less pain, and having a greater advantage (p<0.05). CONCLUSION Endoscopic treatment of recurrent middle ear cholesteatoma with external ear canal flap is an effective surgical method, performed by experienced surgeons. Its efficacy is similar to that of endoscopic mastoid approach surgery, with less time and less pain.