RU2317030C1 - Method for plasty of meatus acusticus - Google Patents

Abstract

FIELD: medicine, otorhinolaryngology.

SUBSTANCE: the present innovation deals with plastic widening meatus acusticus with either inferior or superior cutaneous fragment. Moreover, at final stage of the plasty in question one should introduce a silicone tube dissected longitudinally and in a twisted form into membranocartilaginous department of meatus acusticus. Then this tube should be unfolded by coinciding its dissected edges; through the opening in the tube mentioned one should sanitize post-surgical cavity at its constant aeration. The present innovation enables to prevent cicatrisation and narrowing of meatus acusticus in post-surgical period and simplify post-surgical care of the wound.

EFFECT: higher efficiency.

1 ex

Description

The invention relates to medicine, mainly purulent osteology, and can be used in the surgical treatment of patients with chronic otitis media and atresia of the auditory meatus.

There is a method of plastic surgery of the ear canal during surgical intervention on the ear (V.K. Lyulko, V.M. Marchenko. "Atlas of ear surgery." Kiev: "Health", 1989).

The known method consists in the fact that the skin section of the ear canal after its dissection is laid on the bottom of the mastoid wound in the form of a flap on the upper or lower feeding leg. The auditory meatus is swabbed with gauze ointment tamponade.

The disadvantages of this method of plastic surgery of the ear canal are scarring and narrowing of the ear canal in the postoperative period, which complicates postoperative wound care. The number of cicatricial complications in the postoperative period reaches 32% of cases. Their frequency is associated with the anatomical features of the structure of the auditory meatus, which, after trepanation of the bone section, loses support and undergoes contraction.

The invention is aimed at the rapid rehabilitation of patients by reducing the number of cicatricial complications in the postoperative period.

The novelty of the claimed method consists in creating a prolonged dilatation of the ear canal while maintaining the possibility of caring for the postoperative wound in the mastoid process of the temporal bone.

The most preferred localization of the application for prolonged dilatation is the membrano-cartilaginous part of the auditory meatus.

The technical means for implementing the claimed method is the known silicone tube with an outer diameter of 8 mm and an inner 6 mm, a wall thickness of 2 mm, a length of 1 to 2 cm, in accordance with the anatomical features of the ear canal of the patient. Structurally optimal is a section of a tube with a longitudinal section, which allows you to soften excessive rigidity of the material and reduce the invasiveness of the process of installing a silicone tube.

A new technical result that can be achieved by the invention is to reduce the morbidity of the silicone tube installation process and the possibility of optimal wound care in the postoperative period in the surgical treatment of chronic otitis media and atresia of the ear canal.

The tube is installed at the final stage of plastic surgery of the ear canal. To do this, it is dissected in the longitudinal direction and in a twisted state is placed in the membranous-cartilaginous part of the ear canal. In it, the tube is straightened, connecting its dissected edges. Previously, the skin of the passage is lubricated with Curiosin gel containing collagen. Through the hole in the tube, sanitation of the postoperative cavity is carried out with its constant aeration and a tampon is installed, after which the behind-the-ear wound is sutured in layers. During dressings, the tube is treated with an antiseptic, the skin of the membranous part of the auditory meatus is treated with Curiosin gel. The average residence time of the tube in the ear canal is 21 days.

Example. Patient Sh., 69 years old, was admitted with a diagnosis of chronic otitis media on the right. Complaints of suppuration from the ear. On examination - hyperemia of the eardrum, marginal perforation, purulent discharge in the ear canal. On a computer tomogram of the temporal bone, a zone of destruction of bone tissue is determined.

General condition - pulse of 100 beats per 1 minute, blood pressure of 140/90 mm Hg, pathology from the cardiovascular system, no parinchymal organs of the abdominal cavity, no chest organs were found.

Preparation for the operation is traditional. After anesthesia, a general cavity surgery was performed on the middle ear according to Stack. They made the plastic of the auditory meatus with the lower flap as described above. The postoperative period without complications. The tube was removed after 20 days. Narrowing of the auditory meatus during observation during the year was not detected.

According to this method, 18 people were operated on, no narrowing of the auditory meatus in the early and late postoperative periods was noted.

The combination of the claimed operation allows to achieve a significant reduction in the number of postoperative complications.

Claims (1)

The method of plastic surgery of the auditory canal, which consists in the plastic expansion of the auditory canal by the lower or upper skin flap, characterized in that at the final stage of the plastic, a silicone tube is inserted into the membrano-cartilaginous part of the auditory canal in the longitudinal direction, twisted, then the tube is straightened by connecting its dissected edges, through the hole in the tube sanitize the postoperative cavity with its constant aeration.