带蒂颞肌筋膜隧道膜瓣在鼓室成形术中的应用

Tympanoplasty with tubed pedicle skin flap of temporalis fasciae

目的探讨带蒂颞肌筋膜隧道皮瓣作为修补及支撑组织应用于鼓室成形术中的临床功效。方法选择病变较轻的中耳炎96耳,其中46耳以带蒂颞肌筋膜隧道膜瓣为修补材料行鼓室成形术I型,另外50耳以游离颞肌筋膜修补鼓膜,作出对比;选择病变较重的中耳炎73耳,其中23耳去除外耳道后壁再以带蒂颞肌筋膜隧道膜瓣作为外耳道后壁软支架,另外50耳行乳突根治术,作出对比。结果经过半年随访,转蒂移植的颞肌筋膜隧道皮瓣愈合良好,该组成活率为97.8%,游离颞肌筋膜组为88.0%,术后听力提高相仿。以带蒂颞肌筋膜瓣作为外耳道后壁软支架的病例组术后半年干耳率91.3%,乳突根治术半年干耳率92.0%,术后半年听力提高前者大于后者,行t检验提示有差别。结论带蒂颞肌筋膜隧道膜瓣可作为良好的修补及支撑组织应用于慢性化脓性中耳炎的手术中。

Objective To investigate the applications of tubed pedicle tunnel skin flap of the temporalis fasciae and its supportive role in tympanoplasty.Methods 96 lesions less otitis media ears,pedicled temporalis myofascial flap was used to repair the tunnel film material tympanoplasty I in 46 ears,the other 50 ears used tympanic membrane free temporal fascia,in contrast;select lesions in heavier ear otitis media 73,23 of which were in the ear canal wall and then were removed to pedicled temporalis fascia flap as a tunnel film canal wall soft support,the other 50 lines had mastoidectomy of ear to make a comparison.Results After six months of follow-up,the transfer tunnel pedicled temporalis myofascial flap graft healed well,the group survival rate was 97.8% and the free temporal fascia group was 88.0%,after raising similar hearing.The pedicled temporalis myofascial flap for canal wall cases of soft-stent group after six months of dry ear had a rate of 91.3%,radical mastoidectomy dry ear rate was 92.0% for six months,six months after hearing the former than the latter increase,line t test prompted a difference.Conclusion The tubed pedicle skin slap of the temporalis fasciae can serve as a good patch or pedestal in tympanoplasty.