两种软骨-软骨膜复合体在鼓室成形术中的应用

Application of two auricular cartilage-perichondrium complexes in tympanoplasty

目的观察比较条栅状软骨-软骨膜和马蹄铁状软骨-软骨膜两种修复技术在鼓室成形术中的疗效。方法回顾分析我科2005～2008年39例(39耳)资料完整的鼓膜穿孔面积>40%患者应用两种类型自身软骨-软骨膜复合体的鼓室成形术,其中条栅状软骨组19例(19耳),马蹄铁状软骨组20例(20耳)。对术后鼓膜愈合率和听力指标进行统计分析。结果术后3个月两组鼓膜愈合率均为100%,而言语频率的术前气骨导差与术后气骨导差的差值,马蹄铁状组优于条栅状组(P<0.05)。结论两种软骨-软骨膜复合体修补技术在修补鼓膜大、中穿孔的鼓室成形术均有较好疗效,术后3个月时马蹄铁状软骨-软骨膜组语频听力的改善优于条栅状软骨-软骨膜组。

Objective To compare the effects of cartilage-perichondrium palisade complex and cartilage-perichondrium horseshoe complex in tympanoplasty for large tympanic membrane perforation. Methods Nineteen patients （19 ears） undergoing tympanoplasty with cartilage-perichondrium palisade complex and 20 patients （20 ears） with cartilage-perichondrium horseshoe complex were compared for postoperative hearing and closure rate of tympanic membrane perforation. Results The closure rates of the tympanic membrane were all 100% in both groups 3 months after the operation, while tympanoplasty with cartilage- perichondrium horseshoe complex resulted in significantly greater improvement of the postoperative air-bone gap in speech frequency. Conslusion Both of the two auricular cartilage-perichondrium complexes produced good effects for repair large tympanic membrane perforation, but cartilage-perichondrium horseshoe complex can achieve better results in speech frequency.