Abstract：
Background: The incidence of re-stenosis or re-atresia after reconstruction of the Outer Ear Canal (OEC) in patients with Congenital Malformation of the Middle and Outer Ear (CMMOE) is very high (up to 48%), and it has been a difficult problem for otologists not being able to solve.Aims/Objectives: To explore new strategies and methods to improve re-stenosis or re-atresia after reconstruction of the OEC in patients with CMMOE.Material and Methods: According to the characteristics of reconstructed OEC (r-OEC) re-stenosis or re-atresia summarized by us, a number of new prevention strategies and methods have been proposed and related patent products have been designed, including the improvement of covering epithelium types and skin grafting methods (7 types), simulated drum ring function to prevent the formation of negative pressure in the cavity, and strengthen postoperative support to reduce skin shrinkage and bone hyperplasia. The postoperative effects of different ages and preoperative OEC malformations are statistically analyzed.Results: The incidence of re-stenosis/re-atresia is 14.3% (5/35) in the thin sectional skin of the temporal scalp overlap splicing skin grafting, which was significantly better than 45.5% (15/33) in the whole piece mosaic splicing and barrel skin grafting from the inner thin sectional thigh skin and overlay splicing other methods, including the inner thigh thin sectional skin, chest medium thick skin and subcutaneous pedicle + chest medium thick skin (p<0.05). The patent artificial drum ring and the model stent of the OEC have obvious effects. The mean operation age of postoperative atresia, stenosis, and good groups are 9.3, 13.1, and 12.5 years old, respectively. The proportion of preoperative atresia is 91.3%, 85.7%, and 57.7%, respectively. The total incidence of re-atresia and re-stenosis of r-OEC for two groups of atresia and stenosis of OEC before surgery is 40.5% (49/121) and 13.3% (8/60), respectively.Conclusions and Significance: The best result is found in overlapping the splicing thin sectional skin of the temporal scalp, combined with artificial drum ring implantation, effective support of postoperative model stent of OEC and post-pubertal surgery selection are new and effective strategies and methods to prevent re-stenosis or re-atresia of r-OEC. Atresia or stenosis of the OEC before the operation is the influence factor of the postoperative effect.
摘要：
背景：先天性中耳和外耳畸形（CMMOE）患者重建外耳道（OEC）后再狭窄或再闭锁的发生率非常高（高达48％），对于耳科医生来说，这是一个难以解决的问题。目的/目标：探索新的策略和方法，以改善CMMOE患者OEC重建后的再狭窄或再闭锁。材料与方法:根据我们总结的重建OEC(r-OEC)再狭窄或再闭锁的特点,提出了许多新的预防策略和方法，并设计了相关的专利产品，包括覆盖上皮类型和皮肤移植方法的改进（7种），模拟鼓环功能，以防止在腔内形成负压，并加强术后支持，减少皮肤收缩和骨质增生。对不同年龄及术前OEC畸形的术后疗效进行统计学分析。结果:颞侧头皮重叠剪接植皮的薄切片皮肤中再狭窄/再闭锁的发生率为14.3%(5/35),在整片拼接和桶式植皮中，明显优于45.5%(15/33)，从大腿内薄截面皮肤和其他方法叠加拼接，包括大腿内侧薄的断面皮肤，胸部中厚皮肤和皮下椎弓根+胸部中厚皮肤(p<0.05)。专利人工鼓环和OEC的模子支架具有明显的感化。术后闭锁的平均手术年龄，狭窄,良好的群体是9.3、13.1和12.5岁，分别。术前闭锁的比例为91.3%,85.7%,和57.7%，分别。术前两组OEC闭锁和狭窄的总发生率分别为40.5%(49/121)和13.3%(8/60),分别。结论和意义：重叠颞叶头皮的薄切片皮肤是最好的结果，结合人工鼓环植入，有效支持OEC术后支架模型和青春期后手术选择是预防r-OEC再狭窄或再闭锁的新的有效策略和方法。术前OEC的闭锁或狭窄是术后疗效的影响因素。
