external ear canal plasty

External ear canalplasty is to reconstruct the external auditory canal and restore its sound transmission to the middle ear to improve the patient's hearing. External ear canal shaping can be performed simultaneously with the primary auricle formation, either alone or in the second stage of auricle formation. Curing disease: Indication External ear canalplasty is suitable for congenital or acquired external auditory canal stenosis or atresia. Contraindications Patients with acute inflammatory lesions in the surgical field should undergo surgery after the inflammation has completely subsided. Unilateral external auditory canal stenosis or atresia, normal contralateral ear hearing can be performed after the age of 16; if bilateral external auditory canal affects hearing, surgery should be performed before preschool, that is, before the age of 5, in order to facilitate its normal language development. Surgical procedure Simple stenosis can be used for incision in the ear, separation of the flap, removal of scar, removal of part of the external auditory canal wall, expansion of the external auditory canal, wound surface graft skin, other can be referred to the following methods. 1. Incision Congenital external auditory canal atresia is often accompanied by auricle and middle ear malformation. A curved incision can be made in front of the auricle and behind the temporomandibular joint (incision with the auricular angioplasty), deep into the bone surface; 2, looking for sinus Use the stripper to separate the incision, cut off part of the subcutaneous tissue, and see local depression or rough bone surface, similar to the posterior superior iliac crest and the screening area, where the bone and air chamber can be removed from the outside to find the sinus sinus, if there is no obvious sign The mastoid bone and air chamber can be removed from the outside to the inside of the temporomandibular joint. The soft tissue can be removed and the bone can be removed directly through the closed bone ear canal. The soft tissue caused by the closure is better. 3, expand the external auditory canal After finding the sinus sinus, the bone wall of the upper drum is removed forward, the wall of the mastoid bone and the air chamber are removed backward, and the bone of the anterior wall of the external auditory canal is repaired to enlarge the external auditory canal. When the outer side wall of the upper drum is removed, the short leg, body and hammer bone of the anvil can be seen, and the outer bone of the drum can be cut forward and downward in order to find out the whole picture of the ossicular chain and the two windows (the vestibular window and the snail window). Dentate tympanoplasty as appropriate. 4, external ear canal skin grafting After the external auditory canal is enlarged, if there is no tympanic membrane, the periosteum or fascia can be used to close the tympanic cavity, and then the external auditory canal and the periosteum or fascia surface can be skinned. The free split-thickness skin can be taken from the inner side of the thigh (method as described above). Before the skin is transplanted into the external auditory canal, it can be sutured into a blind tube barrel and then implanted into the external auditory canal. The inner end is pressed against the artificial tympanic membrane, the outer end is sutured with the periosteum and skin of the external auditory canal, and the iodoform gauze is placed in the leather tube. It is closely attached to the surrounding bone surface, and the ear is pressure-wrapped.

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