一例唐氏综合征双侧先天性外耳道狭窄患者接受水下经耳道内镜耳外科 canalplasty 手术

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中文摘要

先天性外耳道狭窄（CAS）有时可能是外耳道（EAC）胆脂瘤的危险因素，可能需要手术治疗。我们报告一例患有唐氏综合征的双侧CAS儿童，接受了双侧水下经耳道内镜耳外科（TEES） canalplasty 手术。病例报告：一名12岁男孩，患有双侧外耳道狭窄，曾因分泌性中耳炎（SOM）在5岁和8岁时行鼓膜置管术失败，转诊至我科接受手术治疗。双侧外耳道非常狭窄且弯曲，无法完全观察到鼓膜。在矢状位计算机断层扫描（CT）图像上使用ImageJ测量骨性外耳道（OEAC）直径。最小费雷特直径右耳为3.05毫米，左耳为2.98毫米。对CAS合并SOM患者进行了双侧水下TEES canalplasty 手术和鼓膜置管术。术后一个月，双侧外耳道上皮化良好，鼓膜易于观察。水下TEES canalplasty 手术微创、安全，并提供清晰的手术视野，因此是外耳道狭窄儿童的一种有用选择。

英文摘要

Congenital aural stenosis (CAS) sometimes can be a risk for external auditory canal (EAC) cholesteatoma and may require surgical treatment. We report a child of Down syndrome with bilateral CAS who underwent bilateral canalplasty with underwater transcanal endoscopic ear surgery (TEES). Case Report: A 12-year-old boy with bilateral EAC stenosis, in whom tympanostomy tube insertion for secretory otitis media (SOM) had failed at 5 and 8 years of age, was referred to our department for surgical treatment. The bilateral EACs were so narrow and curved that the tym-panic membranes could not be entirely observed. The osseous EAC (OEAC) diameters were measured on sagittal computed tomography (CT) images with ImageJ. The minimum Feret diameter was 3.05 mm in the right ear and 2.98 mm in the left ear. Bilateral canalplasty with underwater TEES and tympanostomy tube insertion was performed for CAS complicated by SOM. One month after surgery, bilateral EACs were well-epithe-lialized and the tympanic membranes were easily observed. Canalplasty with underwater TEES is minimally invasive, secure, and provides a clear surgical field, and is therefore a useful option for children with EAC stenosis.