耳屏软骨修补鼓膜大穿孔32例的临床观察

Clinical Observation in 32 Cases of Myringoplasty with Tragic Cartilage in Large Tympanic Perforation

【目的】探讨耳屏软骨作为移植材料用于鼓膜大穿孔修补术的临床效果,并介绍这一方法的临床手术要点及技巧。【方法】对我院2007年4月-2009年4月收治的32例(32耳)鼓膜紧张部大穿孔病例,并根据大穿孔的不同类型,采用自体耳屏软骨作为移植材料完成I型鼓室成型术,所有病例均采用内植法I期完成。【结果】手术后并发症为术后3d出现1例耳屏血肿,4例在术后2～3周出现鼓膜感染,经及时处理均获得治愈;手术后无术耳听力下降及再穿孔发生,无鼓膜内陷及粘连等并发症。经随访1年以上,鼓膜穿孔32耳均达到完全愈合(100%)。【结论】采用耳屏软骨作移植材料具有取材方便,便于植入,抗感染性强等特点;对于紧张部大穿孔的病例术后临床效果好,值得推广。

Objective To summarize the experience and explore the clinical application of myringoplasty with autogenous tragic cartilage in large tympanic perforation.Methods In this study,we retrospectively analyzed 32 cases（32 ears） of myringoplasty in large perforation with autogenous tragic cartilage performed between April 2007 and April 2009.Result All patients were followed up more than 1 year.The global closing rate was 100%,nearly no complications but 1 case of tragic hematoma and 4 cases of infection of tympanic membrane were happened,which were all cured after opportune treatment.Conclusion Myringoplasty with tragus cartilage is a easy-performed and useful technique for tympanic membrane perforations.With optimal choice at indication and correct treatment to complication,we got higher rate of graft success in large perforation.