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鼓膜切开术(耳管)

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ID: ANH00031chis
医学动画文字记录:鼓膜切开术是一种去除中耳积液,使两侧鼓膜恢复相等气压的外科手术。耳由三个主要部分组成:外耳、中耳和内耳。外耳包括收集声波的耳郭和将声波传送到鼓膜的耳道。鼓膜是一层纸一样薄的组织,将外耳和中耳分开。声波使鼓膜振动,鼓膜振动中耳内的三个小骨,即锤骨、砧骨和镫骨,这些小骨将声音振动传递到内耳。内耳将振动转换成电信号,由听觉神经接收,发送到大脑,并解释为声音。这个复杂的过程是瞬间发生的,使我们能够听到周围发出的声音。为了使鼓膜正常振动,中耳内的气压必须与耳外的气压相同。空气通过咽鼓管进入中耳。当你打哈欠并听到砰的一声时,咽鼓管刚好可以输送气泡到中耳来平衡压力。感染、过敏、肿块或腺样体肿大可阻塞咽鼓管,使液体积聚在中耳。液体会阻止鼓膜正常振动,阻碍声音通过中耳的正常传输,从而可能导致听力损失。在某些情况下,液体可能感染细菌,导致中耳炎或耳部感染。进行鼓膜切开术的原因包括:引流耳内超过3个月的积液,治疗抗生素无法清除的慢性耳部感染,恢复积液引起的听力损失,防止儿童听力损失导致的语言发育延迟,或者检测中耳积液中的细菌。在手术前,先建立静脉通路。在大多数情况下,采取全身麻醉使患者在整个手术过程中处于睡眠状态。外科医生将用手术刀或激光器在鼓膜上做一个小切口,并将中耳中的液体排出。在许多情况下,医生通过切口放置通气管或聚乙烯(PE)管。这个小管子会排出手术后积聚的液体,让空气进入中耳,以帮助中耳干燥。如果有必要,医生会对另一只耳朵重复这个过程。整个过程需要30~60分钟。鼓膜上的切口会自行愈合,所以不需要缝合。手术后,患者将被送往恢复室进行监护。儿童在手术后可能会烦躁,应该鼓励他们吃和喝任何他们能耐受的东西。如果您的孩子有疼痛,避免使用阿司匹林,可使用特定年龄剂量的对乙酰氨基酚。如果需要额外缓解疼痛,医生会推荐其他选择。聚乙烯管通常在几个月内自行脱落。

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