CAJ | 학술논문

目的：探索先天性外耳道闭锁/狭窄耳道再造术后防止再闭锁/狭窄新的策略与方法。方法根据作者临床观察再造耳道再闭锁/狭窄的特点，提出了一系列新的预防策略和方法，并研究、设计了相关专利产品。包括改善覆盖上皮种类与方法、模拟鼓环功能、加强术后支撑与扩张。结果再狭窄/闭锁发生率在中厚皮片拼接法16.9%（10/59），明显低于替尔氏皮片桶状植皮34%(17/50)(p<0.05)与拼接植皮45.5%(15/33)(p<0.01)，而后两者间及其它方法间无明显差异(p>0.05)；人工鼓环模拟鼓环功能效果明显；外耳道扩张器与耳道模型支架能起明显的扩张和支撑作用。结论中厚皮片拼接加人工鼓环置入及术后有效的支撑和扩张是防止再造外耳道再狭窄或闭锁新的有效的方法，在临床值得推广应用。
목적：탐색선천성외이도폐쇄/협착이도재조술후방지재폐쇄/협착신적책략여방법。방법근거작자림상관찰재조이도재폐쇄/협착적특점，제출료일계렬신적예방책략화방법，병연구、설계료상관전리산품。포괄개선복개상피충류여방법、모의고배공능、가강술후지탱여확장。결과재협착/폐쇄발생솔재중후피편병접법16.9%（10/59），명현저우체이씨피편통상식피34%(17/50)(p<0.05)여병접식피45.5%(15/33)(p<0.01)，이후량자간급기타방법간무명현차이(p>0.05)；인공고배모의고배공능효과명현；외이도확장기여이도모형지가능기명현적확장화지탱작용。결론중후피편병접가인공고배치입급술후유효적지탱화확장시방지재조외이도재협착혹폐쇄신적유효적방법，재림상치득추엄응용。
Objective To explore new strategies and methods to prevent re-atresia/restenosis of reconstructed exter?nal auditory meatus (Re-EAMs) for congenital aural atresia/stenosis patients. Methods according to the reatresia/resteno?sis characteristics of Re-EAMs observed by the authors, a series of new prevention strategies, methods and relevant patent products are designed, measures include in improving types and methods of the covering epithelium with all kinds of free skin&skin flap, simulating function of the tympanic rings and supporting&expanding Re-EAMs Results the restenosis/reatre?sia rate split for thickness skin graft by mosaic 16.9%(10/59) is significantly lower than those of Thiersch’s skin graft in bar?rel-like 34%(17/50) (p<0.05) and mosaic 45.5%(15/33) (p<0.01), and there was no difference between the later two and oth?er measures (p>0.05). The artificial tympanic ring make good effect, and the EAM expandor and EAM model bracket execute the function well. Conclusion It is a new effective method to prevent restenosis/reatresia of the Re-EAMs) by mosaic grafting free thickness skin , implanting artificial tympanic ring, and supporting&. expanding Re-EAMs by EAM expandor and EAM model bracket, and worth of application .