Endoscopic Medial Reepithelization for Inflammatory Canal Stenosis.
Endoscopic Medial Reepithelization for Inflammatory Canal Stenosis.
复制标题
DOI：
10.1097/mao.0000000000003625
复制
发表时间：
2022-09-01
影响因子：
2.1
通讯作者：
Tward, Aaron D.
中科院分区：
文献类型：
--
作者：
Scaria, Sonia M.;Tward, Aaron D.
炎症性外耳道（EAC）狭窄是由炎症细胞浸润、水肿和内侧外耳道最终硬化引起的，导致完全阻塞和传导性听力丧失。目前的治疗方法包括手术切除受影响的区域，并通过耳后切口扩大和重新上皮化EAC，但据报道这种情况复发的频率很高。我们的目的是评估经鼻内窥镜治疗作为耳道成形术的替代方法的可行性，并了解其对复发率的影响。回顾性病例回顾三级转诊中心纳入4例双侧传导性听力损失伴炎症性耳道狭窄患者，均伴鼓膜粗大增厚。患者接受内窥镜切除梗阻性组织，并通过裂厚皮肤移植进行再上皮化。术后气骨间隙（ABG），缺乏复发，主观报告听力改善，缺乏引流。8 / 8耳（n = 4例）听力明显改善。在平均90个月的随访时间（42-189）中，未观察到任何患者复发。ABG平均下降13.40 dB (SD = 9.0)，术前和术后纯音平均ABG差异有统计学意义（p = 0.0008; n=7）。内镜下治疗炎性EAC狭窄无需耳后切口，临床改善，复发率低。
Inflammatory External Auditory Canal (EAC) Stenosis arises from infiltration of inflammatory cells, edema and eventual sclerosing of the medial EAC, leading to complete obstruction and conductive hearing loss. Current treatment includes surgical resection of the affected area with widening and reepithelization of the EAC via post-auricular incision, but the condition is reported to recur with high frequency. Our aim was to assess the feasibility of endoscopic transcanal treatment as an alternative to post-auricular canalplasty and understand its effect on recurrence rates. Retrospective case review Tertiary referral center 4 patients were included who had bilateral conductive hearing loss and inflammatory canal stenosis, all with gross thickening of the tympanic membrane. Patients underwent endoscopic removal of obstructive tissue and reepithelization with split-thickness skin grafting. Post-operative air-bone gap (ABG), lack of recurrence, subjective reporting of hearing improvement, and lack of drainage. 8 out of 8 ears (n = 4 patients) had significant improvement in hearing. No recurrence has been observed in any of the patients over a mean follow-up time of 90 months (range =42–189). Average reduction in ABG was 13.40 dB (SD = 9.0) with a statistically significant difference between the pure tone average pre-operative and post-operative ABG (p =.0008; n=7). Endoscopic treatment of Inflammatory EAC Stenosis obviates the need for post-auricular incision and results in clinical improvement with a favorable recurrence rate.