耳后进路Over-Under法鼓膜修补术60例

Over-under myringoplasty in 60 cases

目的探讨鼓膜大穿孔合并外耳道狭窄手术修补方法。方法对60例(62耳)鼓膜大穿孔合并外耳道狭窄病例行耳后进路Over-Under法鼓膜修补术,随访0.5～1年,观察鼓膜穿孔愈合率及术后听力变化。结果 60例(62耳)鼓膜大穿孔病例,穿孔愈合58耳(占93.5%),听力提高53耳(占85.5%),无鼓膜外侧愈合及皮片胆脂瘤发生。结论耳后进路Over-Under法鼓膜修补术是鼓膜大穿孔合并外耳道狭窄病例合适的手术方式。耳后进路能提供良好的暴露,有利于制作鼓膜移植床;Over-Under法能较为方便地安放移植膜并提供较高的稳固性,避免鼓膜与鼓岬粘连。

Objective To explore the approaches to repair large tympanic perforation complicated with narrowed external auditory canal.Methods Over-under myringoplasty was performed in sixty patients（62 ears） who suffered from large tympanic perforation and narrowed external auditory canal.Half to one year follow-ups were carried out to observe the changes of hearing ability and healing rate of the perforations.Results Successful healing was achieved in 58 ears with the healing rate at 93.5%.53 ears（85.5%） demonstrated improved hearing ability.No one-sdie healing of the eardrum or cholesteatoma of skin graft occurred.Conclusion Over-under myringoplasty is a satisfactory method to treat patients with large eardrum perforation and narrowed external auditory canal.It provides good exposure to ease eardrum transplantation.Moreover,it is helpful to place the graft stably and prevent possible adhesion between the eardrum and promontory.