前部外耳道皮瓣在修补鼓膜大穿孔中的应用

Application of the anterior plastic meatal flaps for the reconstruction of large tympanic membrane perforation

目的应用外耳道前部皮瓣修补鼓膜大穿孔并评价其效果。方法对70例应用外耳道前部皮瓣鼓室成形术的患者进行回顾分析。结果鼓膜愈合的有效率为95.7%,3例因术后感染再穿孔,但穿孔面积均小于50.0%;术后听力提高或维持术前水平;平均骨气导差(500、1 000、2 000、4 000 Hz)基本达到10 dB以内;与术前相比,听力提高,骨气导差均值明显缩小,差别有统计学意义(P值均<0.01)。结论前部外耳道皮瓣鼓室成形术可有效治疗鼓膜大穿孔,尤其是前部穿孔。

Objective To evaluate the effectiveness of anterior plastic meatal flaps for the reconstruction of large tympanic membrane perforation.Methods Seventy patients who had undergone the anterior plastic meatal flap tympanoplasty were retrospective studied.Results The effective rate of tympanic membrane healing was 95.7%.Three patients had tympanic membrane perforation for the second time because of postoperative infection,but less than 50.0%.There was hearing improvement or no postoperative hearing loss compared with preoperative hearing in all patients.The average air-bone-gap（500,1 000,2 000,4 000 Hz） of all patients after surgery was within 10 dB.Compared with preoperative,the average air-bone gaps in patients reduced significantly and the hearing levels in patients were significantly higher（P0.01）.Conclusion The anterior plastic flap tympanoplasty can effectively treat tympanic membrane perforation,especially large anterior tympanic membrane perforation.