Objective: To introduce a new self-developed irrigation device(SID) that does not employ a sheath or an irrigation-suction system and evaluate to its efficiency in transcanal endoscopic ear surgery (TEES) for attic cholesteatoma. Methods: 38 patients who were subjected to TEES for attic cholesteatoma between October 2019 to June 2021 were included in this study, including 17 males and 21 females with an average age of (38.6±11.9) years. SID and underwater continuous drilling were used during operation. Width of endoscope and irrigation speed were measured when SID was applied. The operating time, surgical view and complications were compared between two groups. Results: The width of the endoscope was 3.5-4.6 mm in diameter and the irrigation speed was 20-40 ml/min when SID was used. SID cleaned the lens at the tip of the endoscope and created a clear field of view during TEES. The operation time was (86.6±18.1) min. The skin of the external ear canal was found injured during operation in 3 patients, but there were no complications such as necrosis of the flap, stenosis of external ear canal, sensorineural hearing loss, facial paralysis and cerebrospinal fluid leakage. Conclusions: SID is simple and enhances the efficacy of TEES, providing a new irrigation choice in TEES for attic cholesteatoma.
目的： 介绍一种简易的耳内镜持续灌流装置的制作，并观察其在上鼓室胆脂瘤手术中的应用。 方法： 回顾性分析2019年10月至2021年6月在西安交通大学第二附属医院接受持续灌流耳内镜上鼓室胆脂瘤手术的患者38例，其中男性17例，女性21例，年龄（38.6±11.9）岁。测量安装灌流装置后耳内镜的直径、使用该装置的灌流速度和手术的时间，分析术中术野暴露情况及术后并发症。 结果： 安装自制灌流装置后耳内镜直径为3.5~4.6 mm，灌流速度可达20~40 ml/min；持续灌流模式下术野清楚，手术时间为（86.6±18.1）min。3例患者术中出现耳道皮肤损伤。无皮瓣缺血坏死、耳道瘢痕狭窄、感音神经性听力损失、脑脊液漏及面神经麻痹等术后并发症。 结论： 该自制持续灌流装置简单、实用，为水下耳内镜上鼓室胆脂瘤手术灌流方式提供了一种新选择。.