耳后进路全翻-内植法鼓膜成形术138例临床分析

Myringoplasty by the pathway behind ear with all turnover and transplant inside:An analysis of 138 cases

目的 探讨鼓膜成形术的改进术式。方法 采用耳后进路 ,取乳突骨膜作为移植材料 ,分离外耳道后壁皮瓣 ,连同残余鼓膜后缘全部翻转向前 ,于皮瓣下植入乳突骨膜封闭穿孔的方法行鼓膜成形术 138例 ,观察疗效。结果 鼓膜穿孔一期愈合 132例 ( 95 .6 5 % ) ,术后 3个月内患者听力均有不同程度提高 ,随访 1年以上无穿孔复发。结论 本术式术野显露清晰 ,取膜及手术可经同一切口进行 ,受穿孔面积及位置因素影响较小 ,适用范围宽 ,成功率高 。

Objective To evaluate an improved myringoplasty.Methods Myringoplasty was made use of the mastoid process periosteum,uncovering the derma of the back wall of external acoustic meatus,reversaling the valve of derma and the back brink of the leftover tympanic membrane together onward,transplanting the mastoid process periosteum under the valve and occluding the perforation.This operation was done in 138 patients and its treatment effect was observed.Results One hundred and thirty two cases (95.65%) got a first stage healing of perforation.The hearing of all patients was improved 3 months after operation.There was no recrudescence of perforation within 1 year's follow up.Conclusion Eyeshot of this operation style is clear.Taking membrane and doing operation may be done in the same cut.It's less affected by the area and size of perforation,the applied extent is wider and the blest rate is higher,so it deserves extensive use.