目的 探讨耳内镜下超薄耳屏软骨-软骨膜修补鼓膜大穿孔的效果.方法 回顾性分析31例应用超薄耳屏软骨-软骨膜行耳内镜下夹层法鼓膜修补术的患者资料,随访6个月,分析术后鼓膜愈合率、听力恢复情况.结果 30例鼓膜愈合,成功率96.8%,无移植物外移、内陷、钝角愈合;术前平均气导听阈为(38.3±3.3)dB HL,骨气导差为(23.5±3.1)dB HL,术后平均气导听阈为(22.3±1.6)dB HL,骨气导差为(6.3±2.5)dB HL,听力较术前提高(P＜0.001).结论 超薄耳屏软骨-软骨膜在耳内镜下鼓膜大穿孔修补术中效果较好,并发症少,是可靠的修复材料,值得临床推广应用.
Objective To investigate the clinical efficacy of endoscopic ultrathin tragus cartilage-perichondrium as graft material for treatment of large tympanic membrane perforations.Methods A total of 31 cases(31 ears)which were diagnosed as chronic suppurative otitis with large tympanic membrane perforation were performed endoscopic myringoplasty with ultrathin tragus cartilage-perichondrium by sandwich technique.The pure tone threshold average(PTA)of speech frequency and the air-bone gap were assessed at 6 month safter surgery.Results Successful closure without reperforation was obtained in 30 of 31 patients(96.8%).There was no graft lateralization,anterior blunting.Average postoperative air conduction and bone-air conduction gap were(22.3±1.6)dB HL and(6.3±2.5)dBHL compared with(38.3±3.3)dB HL and(23.5±3.1)dB HL preoperatively(P＜0.001).Conclusions The ultrathin tragus cartilage-perichondrium is liable repair material for large tympanic membrane perforation with excellent graft take and significant improvement of hearing,which is worthy of clinical promotion.
李鹏;钟玉红;李晓雪;钟庆雯;蔡开贵;汤素琴;苏娟
广州市花都区人民医院耳鼻咽喉科(广东广州 510800)广州市第一人民医院耳鼻咽喉头颈外科(广东广州 510180)
鼓膜穿孔;鼓膜成形术;内镜;软骨-软骨膜
tympanic membrane perforation;myringoplasty;endoscopy;cartilage-perichondrium
《广州医药》 2024 (003)
284-288 / 5
广州花都区科技计划项目(21-HDWS-041)
10.3969/j.issn.1000-8535.2024.03.011
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