先天性耳前瘘管简介精品课件

先天性耳前瘘管简介 姓名：马磊 学号：20081922 疾病原理： 先天性耳前瘘管是常见的耳科疾病。为胚胎期形成耳廓 的第一、第二腮弓的小丘样结节融合不良或第一腮沟封闭不 全所致。瘘管是一种可有分枝而弯曲的盲管，其外口常位于 耳轮脚前上方。管腔盖有复层鳞状上皮，腔内含有鳞屑物， 挤压瘘口周围，偶有少许粘稠皮脂腺样物自瘘口溢出。 临床表现： (1) 未感染时，无症状，或挤出少许粘液、皮脂样物。 (2) 感染时，局部肿痛，化脓；反复感染可形成脓瘘或瘢痕。 治疗方案： 无症状者不需治疗，若有感染化脓，应予抗生素等抗感染治 疗，或脓肿切开引流，局部换药等治疗，待感染控制，局部 痊愈后，再行瘘管切除术，术前注入少许美蓝于瘘管内，并 将探针谈如管腔作为引导。然后将瘘管黑或者其分支一次彻 底切除。若遗留部分瘘管感染复发，再行手术即甚困难。 就诊指南： 1、若无感染史者，不必处理。 2、在急性感染时，全身应用抗生素控制炎症，对已形成脓 肿者，则应先切开引流。 3、有感染史者可待感染控制后，行瘘管切除术。 4、饮食上宜清淡，以瘦肉或鲜蛋为主，忌海鲜鱼虾。 几个简单的问题： 1、先天性耳前瘘管会影响听力吗？ 答：绝对不会。先天性耳前瘘管是形成耳廓的第一、第 二腮弓的小丘样结节融合不良或第一腮沟封闭不全所致，不 影响耳朵内部构造，所以不会影响到听力。 几个简单的问题： 2、先天性耳前瘘管有遗传性吗？ 答:本病属外显不全的常染色体显性遗传性疾病。而且临 床证明有遗传性。但由于发作感染的概率不是很高，所以并 不常见一家有多人发病。 几个简单的问题： 3、耳前瘘管的治疗方法是什么？ 答：一般来说，无症状者不需要治疗。若有感染化脓， 可给予抗生素或磺胺类药物治疗，如青霉素，每次80万单位 ，肌肉注射(注意做过敏试验)；或红霉素，每次0.25g，每日3 次，口服。若形成脓肿应及时切开，排脓引流，局部清洁消 毒，碘伏纱条换药；待红肿消失，感染控制后可行瘘管切除 术，务必一次彻底切除，否则遗留部分瘘管感染复发，再行 手术效果甚差。 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