中耳术后并发耳廓软骨膜炎致耳廓畸形——1例病例报告及文献回顾

目的:通过报道1例中耳术后并发耳廓软骨膜炎致耳廓畸形患者的病历资料,以加强临床医师对该疾病的认识与防范。方法:对本例患者的病历资料进行回顾性阐述,结合该患者的临床特点揭示中耳术后并发耳廓软骨膜炎的发生发展过程,并通过文献回顾阐述该疾病的发病原因、病原学特点及治疗方法。结果:耳廓软骨膜炎是耳科手术术后较为棘手但相对少见的并发症,最为常见铜绿假单胞杆菌感染所致。治疗方法视患者病情而定,包括抗菌药物应用、脓肿切开引流、病变软骨切除术。对于合并糖尿病的老年患者中耳术后更易引发耳廓软骨膜炎,且疗程更长、预后更差。结论:中耳术后并发耳廓软骨膜炎临床需警惕,对合并糖尿病的老年患者应多加防范;早诊断,早治疗,避免增加患者痛苦、加重其经济负担,并与患者做好充分沟通,避免医疗纠纷的发生。

Auricular Perichondritis induced Malformation Secondary to Middle Ear Surgeries: a Case Report and Literature Review

ABSTRACT Objective: To improve the doctor''s medical knowledge for auricular perichondritis through reporting a patient who was admitted for auricular perichondritis after middle ear operation. Methods: The clinical characteristics of the case were stated retrospectively. The aetiology, etiology and treatment methods of auricular perichondritis were reviewed. Results: Auricular perichondritis is a relative rare complication after otological surgery, and is usually caused by Pseudomonas aeruginosa infection. Treatment methods depend on the patient''s condition, included antibiotic drugs, abscess drainage and cartilage resection. For the older patient with diabetes mellitus, auricular perichondritis is more likely to occur with longer course and worse prognosis. Conclusion: Auricular perichondritis after middle ear surgery should be guard against, and more precautions should be taken for the older patient with diabetes mellitus. Early diagnosis and treatments, decreasing patient''s painful and economic burden, full communication with patients is needed to avoid the risk of medical disputes.