双切口隧道法联合耳前组织及软骨整块切除治疗耳前瘘管的效果及预后

doi:10.3969/j.issn.1006-5725.2024.22.010

Abstract

Abstract:

Objective To investigate the efficacy and short-term prognosis of the treatment of complex preauricular fistulas by double-incision tunneling combined with total resection of preauricular tissue and cartilage. Methods The data on 134 children with complicated preauricular fistula admitted to the hospital from January 2018 to July 2022 were retrospectively analyzed. According to the treatment method， they were divided into a study group （68 undergoing double-incision tunnel combined with preauricular tissue and cartilage resection） and a control group （66 receiving preauricular tissue and cartilage resection）. Both groups were followed up for one year. The conditions of surgery， pain， postoperative incision healing， aesthetics of incision healing， complications and short-term prognosis were compared between the two groups. Results There was no significant difference in the amount of blood loss between the two groups （P > 0.05）. The surgical duration was longer in the study group than in the control group （P < 0.05）. There was no significant difference in Pain Behavior Scale （FLACC） scores between the two groups at hours 4 and 24 after surgery （P > 0.05）. There was no significant difference in wound healing between the two groups （P > 0.05）. The SBSES score of the study group was higher than that of the control group （P < 0.05）. There was no significant difference in the total complication rate between the two groups （P > 0.05）. No recurrence occurred in both groups during postoperative follow-up. Conclusion Double-incision tunnel combined with resection of preauricular tissue and cartilage for preauricular fistula can completely remove fistula tissue. Incision healing is satisfactory， safe and reliable. As compared with the total excision of preauricular tissue and cartilage， double-incision tunnel combined with total excision of preauricular tissue and cartilage has more advantages in aesthetics of incision healing.

Key words: double-notch tunnel method, resection of preauricular tissue and cartilage, complex preauricular fistula, prognosis

CLC Number:

R764

Zhijie XIA,Jun LI,Qian GAO,Zhicheng LI,Zhongfang. XIA. Effect and prognosis of preauricular fistula treated by double⁃incision tunnel combined with preauricular tissue and cartilage resection[J]. The Journal of Practical Medicine, 2024, 40(22): 3179-3183.

Figures/Tables 7

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References 25

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组别	性别/例		年龄/岁	体质量/kg	病变部位/例			抗感染治疗次数/次
组别	男	女	年龄/岁	体质量/kg	双耳	右耳	左耳	抗感染治疗次数/次
对照组（n = 66）	30	36	5.16 ± 0.93	18.98 ± 1.05	13	25	28	4.23 ± 0.65
研究组（n = 68）	36	32	5.09 ± 0.89	19.31 ± 1.16	10	20	38	4.09 ± 0.59
t/χ ² 值	0.751		0.445	1.725	2.433			1.306
P值	0.386		0.657	0.087	0.296			0.194

组别	手术时间/min	术中出血量/mL
对照组（n = 66）	35.69 ± 3.49	15.69 ± 2.12
研究组（n = 68）	37.52 ± 4.01	16.41 ± 2.23
t值	2.814	1.914
P值	0.006	0.058

组别	术后4 h	术后24 h
对照组（n = 66）	2.41 ± 0.42	2.85 ± 0.31^?#
研究组（n = 68）	2.35 ± 0.39	2.92 ± 0.29^?#
t值	0.857	1.350
P值	0.393	0.179

组别	甲级愈合	乙级愈合	丙级愈合
对照组（n = 66）	64（96.97）	1（1.52）	1（1.52）
研究组（n = 68）	67（98.53）	1（1.47）	0（0.00）
Z值	0.617
P值	0.538

组别	SBSES评分
对照组（n = 66）	3.97 ± 0.45
研究组（n = 68）	4.13 ± 0.41
t值	2.153
P值	0.033

Effect and prognosis of preauricular fistula treated by double⁃incision tunnel combined with preauricular tissue and cartilage resection

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组别	切口感染	暂时性面瘫	总并发症发生率
对照组（n = 66）	2（3.03）	1（1.52）	3（4.55）
研究组（n = 68）	1（1.47）	0（0.00）	1（1.47）
χ ² 值			1.093
P值			0.296

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