组织工程与重建外科杂志2025，Vol.21Issue(6)：581-585,5.DOI:10.3969/j.issn.1673-0364.2025.06.010
耳内镜放射性外耳道骨坏死切除游离皮瓣修复术对患者临床症状及生活质量的影响
Effects of otoscopic resection of external auditory canal osteoradionecrosis with free flap repair on patients'clinical symptoms and quality of life
摘要
Abstract
Objective To explore the effect of otoscopic resection of external auditory canal osteoradionecrosis with free flap repair on patients'clinical symptoms and quality of life.Methods Sixty patients diagnosed with radiation-induced osteonecrosis of the external auditory canal from December 2021 to December 2023 were selected.The patients'previous medical history,otoendoscopy and pathological examination all supported the clinical diagnosis of radiation-induced osteonecrosis of the external auditory canal after radiotherapy for nasopharyngeal carcinoma.Moreover,CT examination indicated that the lesion was limited to the external auditory canal,and soft tissue shadows could be seen in the ear canal.In cases where free dead bone forms in the ear canal,there is a skin defect in the necrotic bone area.All the included patients underwent otoscopic resection of external auditory canal osteoradionecrosis with free flap repair,and the effects of the surgical treatment on the clinical symptoms and quality of life of the patients were observed.Results All 60 patients included in the study successfully completed the surgery.Postoperative follow-up ranged from 3 to 9 months.The clinical cure rate was 86.67%(52/60).Specifically,patients with clinical stage I had a cure rate of 93.33%(42/45),while those with clinical stage Ⅱ had a cure rate of 66.67%(10/15).Comparison of clinical efficacy between different clinical stages revealed a statistically significant difference(P=0.019).The main clinical symptoms such as recurrent pus,ear pain,restricted mouth opening,and hearing loss were significantly improved after otoscopic resection of external auditory canal osteoradionecrosis and free flap repair(P<0.05).The improvement of postoperative clinical symptoms in patients with clinical stage Ⅰ was better than that in patients with clinical stage Ⅱ,but the difference was not statistically significant(P>0.05).The patients'quality of life showed a significant improvement trend after otoscopic resection of external auditory canal osteoradionecrosis with free flap repair(P<0.05),and no significant difference was seen between the patients with clinical staging type Ⅰ and type Ⅱ(P>0.05).Conclusion Clinical efficacy of otoscopic radiolucent excision of necrotic bone in the external auditory canal with free flap repair can alleviate patients'clinical symptoms and improve their quality of life.关键词
鼻咽癌/放射性骨坏死/外耳道/游离皮瓣修复术/生活质量Key words
Nasopharyngeal carcinoma/Radioactive osteonecrosis/External auditory canal/Free flap repair/Quality of life分类
医药卫生引用本文复制引用
邓华瑞,戴如立,林广明,黄潞..耳内镜放射性外耳道骨坏死切除游离皮瓣修复术对患者临床症状及生活质量的影响[J].组织工程与重建外科杂志,2025,21(6):581-585,5.基金项目
湛江市医药应用和疾病防治技术研究专题资助项目(项目编号:2022A01202). （项目编号:2022A01202）
