嵌入法蝶形软骨鼓膜成形术的临床应用

Clinical study on inlay butterfly cartilage myringoplasty

目的探讨嵌入法蝶形软骨鼓膜成形术的临床应用。方法选择中央型鼓膜穿孔患者38例38耳，应用嵌入法蝶形软骨鼓膜成形术，同期内植法颞肌筋膜鼓膜成形术46例46耳作为对照组。结果术后6个月随访，鼓膜愈合率软骨组为92．1％，对照组为91．3％，两组比较差异无统计学意义（P〉0．05）；纯音测听复查示平均气导提高〉10dB及平均气骨导差〈10dB的发生率差异同样无统计学意义（P〉0．05）。已愈合患者随访12～38个月，软骨组无鼓膜再穿孔；对照组再穿孔4耳，粘连2耳。结论嵌入法蝶形软骨鼓膜成形术是一种简单、成功率高的技术，其远期愈合及听力恢复效果稳定，具有临床实用价值。

Objective To evaluate the application of the inlay butterfly cartilage graft technique in myringoplasty. Methods Thirty-eight ears in 38 patients （experiment group） with dry central drum perforations were treated with inlay butterfly cartilage myringoplasty, and 46 ears in 46 patients with underlay temporalis fascia myringoplasty （control group）. Results After a mean follow-up of 6 months, the healing rate did not differ between two groups （92.1% in experiment group, 91.3% in control group, P〉 0.05）. Average pure-tone hearing threshold improved than 10 dB and closure of the air-bone gap （ABG） within 10 dB were not different （P 〉 0.05 ）. The cured patients were followed up for 12-38 months, there was no ear perforation of drum in experiment group, but 4 ears in control group. Conclusion Inlay butterfly cartilage myringoplasty is the reliable and ideal method for treating dry central drum perforation with high success rate.